UC-NRLF 


B    3    IDA    §72 

ain  \jv  i  liNE  OF  THE 

PIRQUET  SYSTEM  OF 
NUTRITION 


Bv 


Djl  CLEMENS  PIRQUET 


191      m\  FY  I  IRRK  Pfflf      Mffl 


IBrecaaEMaggrf 


bai&SaKsssess 


AN  OUTLINE  OF  THE 

PIRQUET  SYSTEM  OF 
NUTRITION 


By 

Dr.  CLEMENS  PIRQUET 

Professor  of  Pediatrics  at  the  University  of  Vienna,  Austria 


..    .  •    •    •  • 

4  • 


» 


■ 


$> 


PHILADELPHIA  AND  LONDON 

W.   B.  SAUNDERS   COMPANY 

1922 


LIBRAE 


Copyright,  1922,  by  W.  B.  Saunders  Company 


MADE  IN  U.  8.  A. 

PRESS  OF 
W.  6.  8AUN0ER8  COMPANY 

PHILADELPHIA 


INTRODUCTION 


In  the  years  1917-1919  I  published  my  new  System 
of  Nutrition  in  four  volumes.  It  is  written  in  German 
and  is  rather  too  large  for  medical  practitioners,  as  it 
contains  many  detailed  protocols  of  the  scientific  ma- 
terial upon  which  the  system  is  based. 

When  I  was  invited  to  be  a  Silliman  Lecturer  at  Yale 
University  in  the  winter  of  1921-1922  several  of  my 
lectures  on  Modern  Pediatrics  were  on  this  subject  of 
nutrition,  and  I  was  asked  by  many  friends  to  prepare 
a  short  book  in  English  which  would  contain  the 
principal  facts  and  the  practical  application  of  the 
system. 

I  have  used  these  lectures  as  a  basis  for  the  present 
book  and  have  added  a  complete  bibliography  of  the 
subject  from  the  years  1917-1922,  the  nem  values  of 
the  principal  food-stuffs,  and  a  table  of  Pelidisi  Indices. 

May  I  use  this  opportunity  to  thank  Drs.  Lewellys 
F.  Barker,  Harriette  Chick,  Elsie  Dalyell,  Alfred  F. 
Hess,  Edward  A.  Park,  and  Charles  L.  Summers, 
who  were  kind  enough  to  help  me  with  the  English 
edition  in  the  way  of  translation  and  correction. 

Clemens  Pirquet. 

Vienna,  Austria, 

AugUSt,  1Q22. 


CONTENTS 


Page 

Body  Measurements  and  Nutrition 11 

Calortes  and  Nems 23 

Feeding  in  the  First  Year  or  Life 35 

Nutritional  Treatment  of  Tuberculosis 46 

Proper  Feeding  as  Preventive  Medicine 58 

Bibliography 68 

Nem  Value  of  the  Principal  Food-stuffs 79 

Pelidisi  Table 89 


1     1 


,  *  -• 


•  ■It  II         »  •  * 


An   Outline   of  the 
Pirquet   System   of  Nutrition 


BODY  MEASUREMENTS  AND  NUTRITION 

Sitting  Height  and  Body  Weight 

The  problem  of  the  body  weight  of  children  is  one 
which  I  have  had  under  consideration  for  a  long  period 
of  time.  How  may  we  know  objectively  in  making  a 
physical  examination  whether  a  child  has  the  amount 
of  muscular  and  fatty  tissue  corresponding  to  his 
height  and  skeleton?  In  a  former  work  I  attempted 
an  empiric  solution  of  the  problem  by  comparing 
Camerer's  median  weights  for  the  various  ages  with 
the  median  heights,  and  on  the  basis  of  these  comput- 
ing the  average  weight  for  any  given  height. 

In  studying  the  relationships  existing  between  the 
heart,  pulse-rate,  and  body  weight  I  discovered  acci- 
dentally that  a  measure  hitherto  used  but  little — L  e., 
t^he  sitting  height  (height  of  the  trunk) — stands  in 
very  close  relationship  to  the  cube  root  of  the  body 
weight. 

The  sitting  height  is  the  height  of  the  trunk  measured 
from  the  surface  of  the  seat  on  which  the  body  rests 

11 


12    THE  PIXQUET  SYSTEM  OF  NUTRITION 

co  the  top  of  the  head.  This  is  ascertained  very 
simply  by  measuring  the  distance  between  the  hori- 
zontal seat  and  a  horizontal  board  resting  on  the  head. 

The  sitting  height  is  perhaps  not  a  theoretically 
exact  measure,  for  it  depends  upon  the  position  of  the 
spine  and  the  compression  of  the  intervertebral  disks. 
Hence  it  varies  with  the  position  of  the  body  as  well 
as  with  the  period  of  the  day  when  it  is  taken,  but  the 
standing  height  is  open  to  the  same  objections.  Every 
unit  of  measurement  which  is  not  applied  exclusively 
to  a  rigid  bone,  but  includes  also  joints,  cannot  be 
considered  as  being  mathematically  exact. 

In  measuring  the  sitting  height  a  child  should  be 
made  to  sit  as  erect  as  possible.  With  a  little  practice 
the  limits  of  error  will  fall  within  1  cm.  in  either 
direction.  Young  infants  are  not  measured  in  the 
upright  position,  but  horizontally.  With  them  the 
distance  is  measured  between  a  vertical  board  pressed 
against  the  seat  and  another  placed  against  the  head. 

I  desire  to  present  here  only  a  few  examples  gathered 
from  a  large  mass  of  anthropometric  material,  which 
have  special  reference  to  the  problem  under  discussion. 

Measurements  of  Standing  Height,  Sitting  Height,  and  Weight 

Standing        Sitting 
height,  height,  Weight, 

cm.  cm.  kg. 

1 .  Fetus  (about  70  days  old) .     26 . 6  17  0.35 

2.  Newborn 50.5  32             2.9 

3.  Eight  years  old 116.0  66  22.3 

4.  Adult 177.0  93  73.3 


BODY  MEASUREMENTS  AND  NUTRITION    13 

The  differences  existing  between  the  smallest  and 
the  largest  individuals  are  very  great.  The  standing 
height  advances  from  26.6  to  177  cm.  Hence  the 
adult  is  6.6  times  taller  than  the  fetus.  The  sitting 
height  shows  a  somewhat  smaller  variation — 17  to 
93  cm.,  i.  e.f  1  : 5.5.  The  weight,  on  the  other  hand, 
shows  a  range  from  350  to  73,300  grams,  i.  e.f  1  :  220. 

The  legs  constitute  the  largest  factor  in  the  differ- 
ences between  the  standing  height  and  sitting  height. 
The  legs  of  the  fetus  and  the  newborn  child  are  rela- 
tively short. 

We  will  now  consider  the  ratio  of  the  cube  root  of 
the  weight  and  the  sitting  height. 

Fetus.    Newborn.  Eight  years    Adult. 

old. 

Weight  in  grams 350         2900      22,300     73,300 

Cube  root  of  above 7.04      14.3        28.1        41.9 

Sitting  height 17.0        32.0        66.0        93.0 

Ratio  ^weight  :  sitting  height    0.415      0.446      0.426      0.450 

This  ratio  represents  a  variation  of  only  0.415  to 
0.45.  The  difference  in  this  ratio  for  the  fetus  and  the 
adult  is  only  100  :  108,  while  the  sitting  heights  have 
a  ratio  of  100  :  547,  and  the  weights  of  100  :  22,000. 

The  relationship  becomes  evident  without  computing 
the  ratio  if  instead  of  employing  the  cube  root  of  the 
actual  weight  we  take  that  of  the  weight  multiplied 
by  10,  This  cube  root  and  the  sitting  height  differ 
but  little:   15.2  and  17,  90.1  and  93. 


14    THE  PIRQUET  SYSTEM  OF  NUTRITION 

Fetus.  Newborn.  Eight  years      Adult, 
old. 

Weight  in  grams  X  10 3500  29,000  223,000  733,000 

Cube  root  of  above 15.2  30.7       60.5  90.1 

Sitting  height,  centimeters 17.0  32.0       66.0  93.0 

Ratio 89.0  96.0       92.0  97.0 


The  variation  in  the  ratio,  ranging  between  89  and 
97,  is  furthermore  equalized  by  the  fact  that  the  thin 
fetus  and  the  thin  eight-year-old  boy  show  similar 
values,  as  do  also  the  robust  newborn  boy  and  the 
adult  of  average  stature.  Hence  it  is  evident  that 
the  relationship  existing  between  sitting  height  and 
weight  is  a  close  one. 

The  relationship  becomes  still  more  distinct  and 
simple  if  we  select  other  more  illustrative  cases: 


Fetus 
about 
90  days 

old.  Newborn.           Adult. 

Weight  in  grams  X  10 6000  27,000  720,000 

Cube  root  of  above 18.2  30             89.5 

Sitting  height  in  centimeters 18.5  30             90.0 

Ratio 98.4  100              99.5 

Cube  of  sitting  height 6332  27,000  729,000 

Weight  in  grams  X  10 6000  27,000  720,000 


A  cube  of  which  one  side  is  the  sitting  height — u  e., 
a  cube  in  which  the  human  being  can  sit  upright — if 
filled  with  water  would  represent  ten  times  the  weight 


BODY  MEASUREMENTS  AND  NUTRITION    15 

of  the  human  body;  or,  in  other  words,  this  cube  is 
capable  of  holding  10  persons  closely  packed. 

We  could  also  express  this  law  by  saying  that  the 
cube  root  of  ten  times  the  weight  in  grams  approxi- 
mately equals  the  sitting  height  in  centimeters. 


j/ 10  weight  =  sitting  height 


or  also 


y^O  weight  =s  j  =  I?? 
sitting  height  l^K) 


If  the  weight  is  higher  than  usual,  the  ratio  will  be 
more  than  Yrnr«  For  instance,  if  a  man  of  90  cm. 
sitting  height  weighs  72.9  kilograms,  his  weight  exactly 
corresponds  to  the  rule,  as  the  cube  root  of  729,000  is 
90.  But  if  he  weighs  10  kilograms  more,  the  formula 
would  be 


^829000      104 
90        "loo 

If,  on  the  other  hand,  this  man  loses  10  kilograms  of 
his  weight  and  weighs  only  62.9  instead  of  72.9,  the 
formula  would  be 

V/629000  =  95 
90  100 

Therefore,  we  have  a  formula  by  which  we  can  judge 
whether  the  actual  weight  corresponds  to  the  average 


16    THE  PIRQUET  SYSTEM  OF  NUTRITION 

weight  expected  of  an  individual  of  a  given  sitting 
height. 

To  make  the  formula  easier  to  remember  I  coined 
a  word  out  of  the  initials  of  the  constituents:  P 
stands  for  Pondus,  the  body  weight  in  grams.  Pe 
recalls  the  fact  that  we  have  to  take  not  the  simple 
weight,  but  pondus  decies,  ten  times  the  weight.  Li 
tells  us  that  the  weight  must  be  converted  into  a  linear 
function  by  taking  the  cube  root  of  it.  Di  means 
division  and  Si,  sitting  height.  The  word,  therefore,  is 
pelidisi.  We  say  the  pelidisi  of  this  man  of  90  cm.  sit- 
ting height  and  72.9  kilograms  is  100;  if  he  puts  on  10 
kilograms  more  weight,  it  will  be  104;  if  he  loses  10 
kilograms,  it  will  be  95. 

It  would  be  asking  too  much  of  the  physician 
to  estimate  the  cube  root  of  the  weight  of  every 
patient  and  afterward  perform  a  division.  But 
this  calculation  is  very  easy  if  he  uses  a  table,  where 
he  has  only  to  look  for  the  headings  and  go  down  a 
line  of  figures  until  he  finds  the  weight.  At  the  angle 
he  then  finds  the  pelidisi.  (See  Pelidisi  Table  on 
page  89.) 

I  have  not  the  space  here  to  present  all  the  material 
on  which  we  tested  this  formula.  We  applied  it  to 
more  than  500,000  individuals,  and  I  wish  to  give  only 
a  resume  of  what  we  found. 

The  variations  in  the  ratio  for  all  age  groups  are 
similar.  Children  who  have  much  fatty  tissue  reach 
the  100  mark,  while  the  thin  individuals  remain  below 


BODY  MEASUREMENTS  AND  NUTRITION     17 

90.  In  the  case  of  adults,  in  addition  to  the  fatty 
tissue  we  must  also  take  account  of  the  musculature, 
which  raises  the  index  about  5  points.  Thin  persons 
fall  under  95,  adipose  persons  range  over  105. 

Why  is  it  that  notwithstanding  the  growth  of  the 
extremities  and  their  correspondingly  increased  weight, 
the  sitting  height  maintains  a  uniform  relation  to  the 
height  of  the  body  in  all  stages  of  growth  from  the 
fetal  to  adult  life?  This  is  due  to  the  fact  that  the 
weight  of  the  extremities  is  compensated  by  the  weight 
of  the  head.  What  is  lacking  in  weight  with  respect 
to  the  extremities  of  the  fetus  is  made  up  by  the 
weight  of  the  head. 

Hence  we  may  use  the  determined  ratio  "Pelidisi" 
for  any  individual  as  an  index  of  changes  in  the 
nutritional  state  of  that  individual. 

Sitting  Height  and  Intestinal  Surface 

As  a  theoretical  point  of  departure  in  the  considera- 
tion of  nutritional  states,  Rubner,  to  whom  we  owe 
the  fundamentals  of  our  modern  conception  of  nutri- 
tion, adopted  the  amount  of  heat  given  off  by  the 
animal  at  rest  and  during  hunger.  The  heat  of  the 
body  is  created  by  the  oxidation  of  the  reserve  sub- 
stances of  the  body,  particularly  fat.  Heat  depends 
upon  two  factors.  On  the  one  hand,  it  is  a  by-product 
of  the  oxidation  necessary  to  maintain  the  life  func- 
tions of  the  organism,  such  as  the  action  of  the  heart 
and  the  lungs,  the  secretion  of  the  glands.  On  the 
2 


18    THE  PIRQUET  SYSTEM  OF  NUTRITION 

other  hand,  in  a  cold  environment  it  is  augmented  by 
more  or  less  spontaneous  movements  in  an  attempt  to 
avoid  cooling  of  the  body  and  to  maintain  a  uniform 
internal  temperature. 

But  deprivation  of  food  and  rest  are  exceptional 
conditions  of  life  which,  although  admitting  of  impor- 
tant physiological  conclusions,  have  little  significance 
ordinarily.  During  normal  times  there  is  no  general 
condition  of  hunger,  and  we  daily  satisfy  our  desire 
for  food.  Rest  also  may  be  tested  experimentally 
only  on  patients  lying  in  bed.  Generally  speaking, 
the  brain  worker  corresponds  more  nearly  than  any 
other  to  the  conditions  imposed  by  the  experiment. 
The  growing  and  active  child,  the  man  engaged  in 
manual  labor,  are  far  removed  from  the  conditions  of 
muscular  rest  and  deprivation  of  food,  and  hence 
show  an  altogether  different  type  of  oxidation  from 
that  of  the  physiologic  experiment. 

As  a  rule  the  human  organism  takes  in  far  larger 
masses  of  food  than  suffice  for  heating  its  furnace  and 
maintaining  the  body  temperature.  The  working- 
man  does  not  eat  for  the  purpose  of  keeping  his  body 
temperature  from  falling.  On  the  contrary,  he  pos- 
sesses a  superabundance  of  heat  which  he  seeks  to 
eliminate  by  evaporation. 

I  assume,  therefore,  as  a  starting-point  of  the  theory 
of  nutrition  not  the  amount  of  heat  given  off  by  the 
body,  but  the  amount  of  oxidizable  intake  in  the 
form  of  food. 


BODY  MEASUREMENTS  AND  NUTRITION    19 

A  good  point  in  Rubner's  theory  is  that  it  brings 
the  oxidation  in  connection  with  a  surface  and  not 
with  a  cube;  but  I  differ  with  him  in  regard  to  which 
surface  and  in  regard  to  whether  we  should  take  as 
a  basis  the  output  of  heat  or  the  intake  of  com- 
bustible food. 

The  law  that  the  production  of  heat  corresponds  to 
a  surface  and  not  to  a  cube  has,  long  before  Rubner, 
been  expressed  by  Rameaux  in  1838,  and  by  Bergman 
in  1847;  the  theory  that  the  output  of  heat  is  not  the 
real  standard  has  been  brought  forward  by  H.  von 
Hoesslin  in  1888.  The  absorbed  oxygen,  this  author 
pointed  out,  is  proportionate  to  the  amount  of  oxygen 
which  is  circulating  in  the  body.  That  amount  has  a 
relation  to  the  cross-section  surface  of  the  blood- 
vessels, and  this  again  is  proportionate  to  tie  two- 
thirds  power  of  the  weight.  Also,  the  amount  of 
food  taken  in  the  body  is  related  to  a  theoretical  in- 
testinal surface,  which  surface  again  is  related  to 
the  surface  of  a  section  of  the  body,  and,  therefore, 
to  a  two-thirds  power  of  weight.  Without  knowing  of 
the  work  of  Hoesslin,  I  myself  had  come  to  similar 
conclusions  as  to  the  importance  of  the  two-thirds 
power  of  the  weight,  and  I  tried  to  find  a  way  of 
easy  calculation  for  a  surface  which  we  could  take  as 
representing  the  absorbing  surface  through  which  the 
food  taken  in  the  body  had  to  pass.  As  I  knew  that 
the  sitting  height  stood  in  a  constant  and  simple  re- 
lation to  the  cube  root  of  the  weight,  the  two- thirds 


20    THE  PIRQUET  SYSTEM  OF  NUTRITION 

power  of  the  weight  could  be  easily  calculated  by- 
taking  the  square  of  the  sitting  height.  As  this 
surface  interested  me  in  regard  to  the  intake,  I  had 
to  find  out  whether  or  not  we  could  bring  it  into  direct 
relation  with  the  absorbing  surface  of  the  intestines, 
and  this  could  be  done  in  a  very  simple  way. 

Henning  had  found  in  1881  that  in  children  as  well 
as  in  adults  the  length  of  the  intestinal  canal  directly 
corresponds  to  the  sitting  height,  a  thing  which  seems 
to  us  now  a  matter  of  course,  as  every  part  of  the  trunk 
in  a  well-proportioned  individual  will  be  proportionate 
to  the  length  of  the  trunk.  But  he  also  had  found  a 
very  simple  relation;  the  length  of  the  intestinal  canal 
on  an  average  equals  ten  times  the  sitting  height. 
Direct  measurements  of  the  surface  of  the  intestines 
gave  for  the  undilated  canal  of  an  adult  about  5000 
sq.  cm.;  for  the  dilated,  about  10,000  cm.;  if  we  take 
a  medium  of  7500  sq.  cm.,  this  corresponds  to  an 
average  circumference  of  about  one-tenth  of  the 
sitting  height.  We  can,  therefore,  have  a  conception 
of  the  absorbing  surface  in  multiplying  ten  times  the 
sitting  height  by  one-tenth  of  the  sitting  height,  or, 
in  other  words,  we  take  the  square  of  the  sitting  height 
as  a  symbol  of  the  absorbing  surface.  I  say  as  a  symbol, 
for  the  absorbing  surface  can  never  be  measured  in  an 
exact  way,  as  it  is  a  most  variable  thing,  and  as  it 
would  always  be  a  point  of  dispute  whether  we  have 
to  take  it  empty  or  filled,  with  or  without  the  surface 
of  the  intestinal  glands,  crypts,  and  villi,  with  or 


BODY  MEASUREMENTS  AND  NUTRITION    21 

without  the  inner  surface  of  the  larger  glands.  The 
important  point  is  that  here  we  have  a  surface  that 
gives  us  a  certain  picture  of  the  absorbing  surface  and 
that  has  a  direct  relation  to  the  two-thirds  power  of 
the  weight. 

The  fact  that  the  two-thirds  power  of  the  weight 
has  a  true  relation  to  the  intake  of  food  could  be 
proved  easily  by  comparing  the  intake  of  mammals  of 
very  different  sizes.  I  give  a  series  of  examples  taken 
from  various  experiments: 


-§■  rt  .*  >>  2  rt  In  u-S     ±"§Pa 

ofco  5-0  ga         ««&     riCu- 

Rat 181  "  58  320  148  0.392 

Newborn  child 2,200  336  152  784  0.429 

Adult 61,400  3,063  50  7,230  0.423 

Ox 632,100  15,200  24  34,200  0.445 

Highest  figure  divided  by 

lowest  figure 3,500  261  13.3  231  1.14 

The  ox  has  a  weight  3500  times  the  weight  of  the 
rat,  but  the  food  he  takes  in  is  not  3500  times  more, 
but  only  261  times;  compared  to  weight,  the  rat  eats 
13.3  times  more  than  the  ox.  It  is  apparent  that  the 
intake  corresponds  much  closer  to  the  two-thirds 
power  of  the  weight,  as  here  the  relation  of  ox  to  rat 
is  only  231  to  1.  But  we  see  the  clearest  expression 
of  the  law  in  the  last  column,  which  expresses  the 
relation  of  the  daily  intake  to  the  intestinal  surface: 


22    THE  PIRQUET  SYSTEM  OF  NUTRITION 

The  rat  takes  0.392  food  units  per  square  centimeter, 
the  baby,  0.429,  the  adult,  0.423,  and  the  ox,  0.445; 
the  division  of  the  highest  by  the  lowest  figure  gives 
only  1.14  compared  to  231  for  surface,  261  for  intake, 
and  3500  for  weight. 

Having  found  these  simple  ways  of  comparison,  I 
spent  about  two  years  in  examining  the  spontaneous 
intake  of  children  and  adults,  and  comparing  these 
figures  with  the  two-thirds  power  of  the  weight  and 
the  square  of  the  sitting  height.  More  than  10,000 
single  day  experiments  have  been  used  for  the  calcula- 
tion. I  cannot  go  into  details  of  this  examination,  but 
shall  give  only  the  results.  The  correspondence  was 
remarkably  close,  and  the  method  of  using  the  square 
of  the  sitting  height  proved  to  be  more  satisfactory 
for  practical  use  because  it  has  the  advantage  over 
the  two-thirds  power  of  the  weight  in  that  it  does  not 
depend  on  the  accessory  surplus  or  lack  of  fat  tissue 
and  muscles,  but  is  rather  related  to  an  ideal  status  of 
nutrition  that  corresponds  to  the  skeleton. 

My  task  for  the  following  two  years  was  to  discover 
simple  principles  upon  which  the  feeding  of  individual 
children  and  adults  could  be  based,  using  the  square  of 
the  sitting  height  as  a  practical  index. 


CALORIES  AND  NEMS 

We  stated  in  the  last  chapter  that  the  intake  of  a 
newborn  baby  was  336  food  units,  and  that  of  an  adult 
3063  units.  These  units  were  not  calories,  but  nems. 
A  "nem"  is  the  nutritive,  combustible  value  of  1  gram 
of  milk,  of  average  human  milk.  The  name  is  com- 
posed of  the  initials  of  "Nahrungs-Einheit-Milch,"  or 
"Nutrition  Equivalent  Milk,"  and  refers  to  a  standard 
human  milk  of  1.7  per  cent,  of  protein,  3.7  per  cent, 
of  fat,  6.7  per  cent,  of  milk-sugar,  as  well  as  to  a  stand- 
ard cow's  milk  of  3.3  per  cent,  of  protein,  3.7  per  cent, 
of  fat,  5  per  cent,  of  milk-sugar. 

Does  such  a  standard  milk  exist?  Does  not  the 
milk  vary  a  great  deal,  and  if  so,  does  not  each  milk 
present  a  different  standard?  Certainly,  milk  varies 
greatly,  especially  in  its  content  of  fats,  but,  never- 
theless, we  are  entitled  to  take  a  certain  theoretical 
average  as  a  standard,  just  as  we  use  the  horsepower 
as  a  standard  for  our  machines,  disregarding  the  fact 
that  every  individual  horse  has  a  different  power. 

The  standard  milk  I  chose  has  a  simple  relation 
to  the  caloric  system,  having  667  small  available 
calories  in  1  gram,  or  667  large  calories  in  1  kilogram; 
2000  small  calories,  therefore  2  large  calories  equal 
3  nems,  or  one  large  calory  equals  1.5  nems. 

23 


24    THE  PIRQUET  SYSTEM  OF  NUTRITION 

But  why  not  take  the  calories  as  they  are?  Why 
introduce  a  new  standard?  There  are  several  reasons 
for  this.  The  calory,  which  dates  from  Lavoisier's 
time,  has  been  very  well  defined  for  the  physicist  as 
the  amount  of  heat  necessary  to  raise  the  temperature 
of  1  gram  of  water  1°  C. — this  is  the  so-called  small 
calory.  The  large  calory  raises  the  temperature  of 
1000  grams  1°  C.  This  is  clear  when  a  bomb  calor- 
imeter is  used,  but  not  if  the  combustion  takes  place 
in  a  living  being.  A  portion  of  the  food  ingested 
is  not  available  for  heat  production,  since  a  fraction 
of  it  passes  off  from  the  body  undigested.  Some  of 
the  physiologists  distinguish,  therefore,  the  net  from 
the  raw  calory,  some  discount  the  unburned  part  in 
the  feces,  some  discount  also  the  unburned  output  in 
the  urine — the  fact  is,  that  every  one  of  the  greater 
schools  of  physiology  has  its  own  definition,  and, 
therefore,  arrives  at  a  different  caloric  value  for  the 
food-stuffs  of  ordinary  use. 

What  we  need  is  a  simple  physiologic  unit.  The 
calory  does  not  supply  it.  Coal,  for  instance,  is  won- 
derfully rich  in  calories  if  you  burn  it  in  an  oven,  but 
it  has  no  food  value,  because  it  passes  the  intestinal 
canal  without  being  absorbed.  If  you  burn  leafy 
sprigs  in  a  calorimeter  the  caloric  value  may  be  large, 
but  if  you  feed  the  same  to  cattle  you  discover  not  only 
that  the  animals  are  unable  to  avail  themselves  of  the 
heat  value  but  also  that  they  actually  lose  weight 
because  of  the  work  of  mastication  and  of  transforma- 


CALORIES  AND  NEMS  25 

tion  of  the  sprigs  into  a  pulpy  mass  that  can  pass 
through  the  intestines.  Because  of  this  the  agricul- 
turists have  long  ago  abandoned  the  caloric  system. 
They  use  different  physiologic  units  of  comparison,  of 
which,  to  my  mind,  the  starch  unit  of  Kellner  is  the 
best.  It  compares  the  amount  of  fat  produced  by  1 
kilogram  of  various  food-stuffs  given  as  a  surplus  to  a 
minimum  ration  with  the  amount  of  fat  produced  by 
ingestion  of  1  kilogram  of  water-free  starch  as  a 
standard.  Both  unit  and  point  of  comparison  seemed 
not  to  be  applicable  to  human  beings,  for  we  do  not 
use  water-free  starch,  and  our  object  is  not  to  produce 
lard.  I  thought  milk  much  more  appropriate  for  a 
practical  unit,  as  it  is  the  first  food  we  give  to  human 
beings.  During  childhood  we  substitute  slowly  other 
materials  for  it.  Moreover,  it  contains  all  the  impor- 
tant food-stuffs,  the  combustibles  (fat  and  carbo- 
hydrates), the  structural  elements  (water  and  salt), 
and  the  proteins  which  can  be  used  both  as  structural 
elements  and  as  combustibles,  and  finally,  the  vita- 
mins. 

This  milk  unit  is  used  as  a  metric  unit,  and  is  com- 
bined with  the  Latin  prefixes  for  metric  fractions, 
and  with  the  Greek  prefixes  for  multiples  of  the  unit: 

A  decinem  means  one-tenth  of  a  nem,  or  the  nutri- 
tive value  of  1  decigram  of  milk,  0.1  gm.,  and  is  written 
1  dn. 

A  centinem  is  written  1  en.,  and  represents  0.01  gm. 

A  millinem  is  written  1  mn.,  and  represents  0.001  gm. 


26    THE  PIRQUET  SYSTEM  OF  NUTRITION 

These  smaller  units  are  used  only  in  the  calculation 
of  the  food  intake  per  square  centimeter  in  its  rela- 
tion to  the  nutritional  surface.  For  instance,  in  the 
above  example,  we  would  say  the  baby's  intake  was 
4.29  decinems  per  square  centimeter,  or  42.9  centinems, 
or  429  millinems. 

In  the  practical  use  of  food-stuffs  we  have  to  make 
use  of  the  larger  units,  namely,  the  multiples  with 
Greek  prefixes: 

A  dekanem  (Dn.)  means  10  nems. 

A  hektonem  (Hn.)  means  100  nems.  This  unit  is 
used  in  the  composition  of  a  recipe  for  a  certain  dish, 
or  of  the  day's  program  for  one  person  or  family. 

A  kilonem  (Kn.)  means  1000  nems.  We  use  it  in 
buying  food-stuffs  for  a  family,  or  making  recipes  for 
a  large  number. 

A  tonnenem  (Tn.),  finally,  represents  the  food  value 
of  1  metric  ton  of  milk:  1000  Kn.,  or  1,000,000  nems. 
We  use  it  in  wholesale  nutrition,  as  in  making  the 
budget  for  the  child  feeding  in  Austria  where  we  have 
been  feeding  400,000  meals  a  day  of  1  Kn.  each.  The 
daily  use,  therefore,  was  400  Tn.  A  train  containing 
60  cars,  16  metric  tons  each,  has  960  metric  tons.  If  the 
content  is  flour,  each  metric  ton  means  5  tonnenems, 
and  the  train  contains  4800  tonnenems.  It  would  give 
4,800,000  meals,  or  sufficient  food  for  twelve  days. 

I  said  that  flour  has  5  tonnenems  in  a  metric  ton.  I 
could  just  as  well  have  said  that  it  contains  5  kilonems 
per  kilogram,  or  as  the  simplest  expression,  5  nems 


CALORIES  AND  NEMS  27 

per  gram.  Flour  has  five  times  the  food  value  of  milk 
weight  for  weight. 

The  food  values  of  all  articles  used  for  human  food 
should  be  determined  by  substituting  a  given  quantity 
of  the  article  for  milk.  This  method  is  being  worked 
out  for  some  food-stuffs  used  in  early  infancy,  but  it 
will  take  years  to  finish  this  experiment  for  the 
very  many  food-stuffs  we  use  for  adults.  Meantime 
we  use  a  chemical  analysis  of  the  food,  discount  the 
percentage  of  combustibles  lost  in  the  urine  and  in  the 
stools,  and  translate  grams  and  calories  into  nems. 

To  shorten  the  chemical  analysis  I  devised  simple 
methods  of  examination,  based  on  the  testing  of  dry 
substances,  fat,  and  ashes,  which  are  easy  to  apply, 
and  give  results  that  are  satisfactory  for  practical  use. 
Cow's  milk,  for  instance,  has  to  be  examined  as  to 
its  fat  content  alone,  and  bread  as  to  its  content  in 
dry  substance.  (See  Nem  Value  of  Principal  Food- 
stuffs, page  79.) 

If  no  special  accuracy  is  required,  we  content  our- 
selves with  the  average  data,  based  on  chemical 
examinations  of  food-stuffs  by  numerous  authors,  and 
collected  by  Konig. 

I  give  some  of  the  most  important  food-stuffs  in  the 
following  table,  which  gives  at  the  same  time  the 
weight  of  1  hektonem  in  grams:  If  1  gram  of  flour  has 
a  food  value  of  5  nems,  20  grams  will  contain  100  nems, 
or  1  hektonem.  The  "hektonem-weight"  of  flour, 
therefore,  is  20. 


28    THE  PIRQUET  SYSTEM  OF  NUTRITION 

Nems  in  1  gram.  Hektonem  weight. 

13£        Pure  fat,  oil 7.5 

12  Butter 8.5 

30  Bacon 10 

6  Sugar,  cocoa 16.7 

5  Wheat    flour,  oat    flour,    biscuit,  rice, 

ham,  fresh  fat  meat,  cheese,  syrup, 

honey 20 

4  White  bread 25 

3|        Dark  bread 30 

2 . 5      Fresh  meat,  eggs 40 

1 .25    Potatoes •. 80 

1  Milk,  green  peas 100 

0.67    Fresh  fruit 150 

0.5      Skimmed  milk 200 

0.4      Turnips,  spinach,  cabbage,  cauliflower, 

fresh  mushrooms 250 

0.2      Lettuce,  cucumbers 500 

Let  us  now  compose  a  meal,  let  us  say  a  good  break- 
fast, for  an  adult,  of  10  hektonems: 

Food  value  in 
hektonems. 

Two  large  cups  of  coffee  with  milk : 

200  gm.  of  water  with  coffee 0 

200  gm.  of  milk 2 

and  2  lumps  of  sugar  in  each  cup: 

17  gm.  of  sugar 1 

Two  rolls  of  white  bread  with  butter: 

50  gm.  of  white  bread 2 

8.5  gm.  of  butter 1 

Bacon  and  eggs: 

80  gm.  of  eggs  (2  eggs) 2 

20  gm.  of  bacon  (2  small  slices) 2 

10  hektonems 


CALORIES  AND  NEMS  29 

Let  us  go  one  step  farther.  We  desire  to  prepare 
for  a  child  for  supper  a  gruel  of  the  food  value  of 
4  hektonems: 

260  grams  of  milk — food  value  of  1  gram  is  one 

nem 260  nems 

16  grams  of  oatmeal  (5x16) 80 

10  grams  of  sugar  (10  x  6) 60 

400  nems  or  4  hn. 

You  see  our  way  of  procedure.  It  is  not  a  calcula- 
tion of  a  given  meal,  but  it  is  a  composition  of  a  meal. 
Using  the  food  values  in  nem  as  the  basis  for  the  com- 
position of  a  meal,  one  must  then  decide  whether  or 
not  the  given  mixture  will  taste  well.  It  is  not  sufficient 
that  the  food  contain  the  given  amount  of  nutritive 
value,  but  it  must  be  composed  and  prepared  in  a 
way  that  is  appetizing.  In  this  way  a  great  number 
of  1  kilonem  recipes  that  are  pleasing  to  the  taste  have 
been  worked  out.    The  following  is  one  example: 

Pudding  with  Mushrooms 

Hektonems.     Grams. 

Butter 4  34 

Eggs 3  3  eggs 

Flour 2  40 

Milk 0.5  50 

Fresh  mushrooms 0.5  125 

The  recipe,  of  course,  gives  explicit  directions  for 
the  preparation  of  the  pudding  by  the  cook,  telling 
how  much  salt  and  pepper  and  onions  have  to  be 
added,  their  slight  nutritive  values  being  disregarded. 

If  we  feed  human  beings  for  a  whole  day,  we  have 


30    THE  PIRQUET  SYSTEM  OF  NUTRITION 

not  only  to  consider  the  combustible  content  of  the 
food  but  also  the  protein  content,  the  water  content, 
furthermore,  the  content  of  the  food  in  vitamins,  in 
salts,  finally  in  cellulose  and  other  indigestible  sub- 
stances. 

For  determination  of  the  necessary  content  in  pro- 
tein of  a  diet  the  physiologists  calculate  the  protein 
used  in  metabolism.  I  approach  the  topic  by  a  differ- 
ent way,  similar  to  my  way  of  simply  taking  the  spon- 
taneous intake  for  determining  the  combustible  values. 
I  tried  to  find  out  what  was  natural,  as  shown  in  actual 
habits,  of  protein  intake  at  different  ages,  in  different 
countries,  and  in  different  animals.  I  did  not  try  to 
reach  absolute  figures  in  grams  of  protein  per  day  or 
per  kilogram,  but  rather  considered  the  protein  used 
in  relation  to  the  amount  of  combustibles. 

It  appeared  that  human  beings  and  domestic  animals 
of  all  ages  are  accustomed  to  take  at  least  10  per  cent, 
of  their  caloric  values  in  the  form  of  proteins,  and 
rarely  take  more  than  20  per  cent,  in  this  form.  These 
two  limits  are  easy  to  remember.  Human  milk  con- 
tains about  10  per  cent,  and  bovine  milk  about  20 
per  cent,  of  protein,  and  we  are  safe  if  we  keep  within 
these  two  limits.  A  less  amount  may  hamper  growth 
and  digestion — growth,  because  proteins  are  among 
the  most  important  substances  for  the  body,  and 
digestion,  since  the  different  juices  of  the  gastric 
intestinal  tract  need  proteins  to  be  effective.  If  sheep, 
for  instance,  are  fed  with  too  little  protein,  they  are 
not  able  to  digest  starch.    On  the  other  hand,  a  sur- 


CALORIES  AND  NEMS  31 

plus  of  protein  is  not  used  as  a  structural  element,  but 
as  a  combustible,  and  it  is  a  very  bad  one,  for  a  part 
of  it  leaves  the  body  through  the  urine  unburnt. 

The  amount  of  protein  contained  in  the  different 
food-stuffs  is  also  brought  in  relation  to  their  value  in 
nem.  If  10  per  cent,  of  the  food  value  is  contained  in 
the  form  of  protein,  we  may  as  well  say  1  dekanem 
(Dn.)  of  protein  is  contained  in  every  hektonem  of 
this  diet.  We  do  not  need  to  make  the  calculation 
more  accurate  than  in  dekanem,  as  our  object  is  only 
to  keep  within  between  10  and  20  per  cent. 

The  food-stuffs  mentioned  above  for  their  content 
in  nems  contain  the  following  amount  of  protein: 

Dn.  protein  in  1  Hn. 

Pure  fat,  oil,  butter none 

Sugar,  syrup,  honey none 

Bacon 0.5 

Potatoes 0.5 

Fresh  fruit 0.5 

Flour,  biscuit,  rice 1 

Bread 1 

Human  milk 1 

Fresh  fat  meat 2 

Cow's  milk 2 

Green  peas 2 

Turnips,  cabbage,  cauliflower 2 

Lettuce  and  cucumbers 2 

Ham 3 

Eggs 3 

Mushrooms 3 

Cheese 4 

Skimmed  cow's  milk 4 

Fresh  medium  meat 4 


32    THE  PIRQUET  SYSTEM  OF  NUTRITION 

If,  for  instance,  we  had  to  determine  the  amount  of 
protein  contained  in  the  breakfast  we  mentioned  above, 
we  would  say: 

Dn.  protein. 
2  hektonems  of  cow's  milk  (2  Dn.  in  a  Hn.)  2x2.4 

1  hektonem  of  sugar,  none 0 

2  hektonems  of  white  bread,  1  Dn 2 

1  hektonem  of  butter,  none 0 

2  hektonems  of  eggs,  3  Dn 6 

2  hektonems  of  bacon,  0.5 1 

13 


This  breakfast  contains  13  dekanems  protein  in  10 
hektonems  of  food,  or  13  per  cent,  of  the  combustible 
value  consists  of  protein.  This  is  within  the  limits  of 
our  estimation.  It  is  not  necessary  to  look  over  each 
meal  for  the  protein  amount,  not  even  for  each  day, 
but  we  do  it  for  the  control  of  a  week's  program. 

As  to  the  special  value  in  protein,  science  is  not  yet 
advanced  enough  to  form  a  clear  and  simple  program. 
As  for  the  vitamins,  we  consider  the  weekly  program, 
to  see  whether  it  contains  milk,  potatoes,  and  green 
vegetables. 

An  important  point  is  the  content  of  the  food  in 
non-digestible  matter.  Small  babies  do  not  need  it,  but 
older  children  and  especially  adults  become  mostly 
constipated  if  they  do  not  ingest  a  certain  amount  of 
cellulose.  Our  rule  is  to  give  every  day  brown  bread 
at  two  meals,  and  once  a  day  green  vegetables  (spin- 
ach, cabbage,  salad). 


CALORIES  AND  NEMS  33 

A  thing  not  to  be  neglected  is  the  amount  of  fluid 
taken  with  the  food.  We  have  not  only  to  consider 
the  water  taken  as  such,  or  in  the  form  of  soup  or  tea, 
but  also  the  water  contained  in  most  of  our  other  food. 
For  instance,  potatoes  or  meat  contain  about  75  per 
cent,  of  water,  and  of  the  foods  like  carbohydrates,  a 
part  is  chemically  water;  even  the  fats  form  water  in 
the  body  on  combustion.  The  water  output  equals 
about  95  per  cent,  of  an  average  diet,  so  there  is  only 
a  slight  error  if  we  consider  the  whole  weight  of  the 
food  as  water,  and  compare  this  "food  weight"  with 
the  food  value  in  nems. 

In  the  former  example  of  a  gruel  containing  400 
nems  we  would  say  in  the  recipe  the  milk  must  be 
boiled  until  the  total  weight  is  reduced  to  200  grams. 
We  had  used  260  grams  of  milk,  16  of  flour,  and  10  of 
sugar,  total  286  grams;  if  86  grams  of  water  are  evap- 
orated out  of  the  milk,  the  remaining  200  grams  will 
contain  400  nems,  or  1  gram  contains  2  nems.  We  call 
such  a  composition  double  strength  food;  in  the  same 
way  we  can  make  triple  strength  food,  which  contains 
three  times  the  nutritive  amount  of  milk ;  we  call  half- 
strength  food  a  composition  which  contains  only  50 
nems  in  100  grams. 

This  is  important,  especially  for  babies,  for  whom 
we  have  to  provide  the  necessary  water,  while  at  the 
same  time  we  must  not  give  too  great  a  volume  as 
food.  If  we  give  too  much  water,  the  baby  is  not  able 
to  drink  as  much  food  values  as  we  wish  it  to  drink, 


34    THE  PIRQUET  SYSTEM  OF  NUTRITION 

and  if  we  give  too  little  water,  the  metabolism  becomes 
disordered.  For  most  children  we  use  about  1.5  nem  in 
a  weight  of  1  gram.  We  never  exceed  a  concentration  of 
three  times  that  of  milk  (3  nems  in  1  gram)  and  rarely 
go  below  the  concentration  of  milk  (1  nem  in  1  gram). 
Finally,  we  have  to  consider  the  question  of  fats. 
From  practical  experience  I  make  it  a  rule  to  order  not 
less  than  10  and  not  more  than  20  per  cent,  of  fats, 
like  butter,  lard,  or  oil.  But  there  is  no  danger  from 
giving  under  the  minimum  of  10  per  cent.,  as  there 
would  be  with  the  proteins.  The  fats,  as  far  as  they 
are  used  as  combustibles,  can  be  fully  substituted  by 
carbohydrates.  The  small  amount  of  fat  necessary  to 
convey  the  fat-soluble  vitamin  can,  to  my  mind,  be 
disregarded  in  practical  feeding  in  normal  times  when 
you  are  able  to  give  a  mixed  diet.  I  have  been  mis- 
understood often  in  my  views  regarding  fat.  I  never 
advocated  a  diet  free  from  fats,  but  only  that  a  sub- 
stitution was  possible  if  the  conditions  of  the  market 
made  it  necessary.  At  the  beginning  of  the  war 
we  had  in  Austria-Hungary,  as  a  sugar  exporting 
country,  a  surplus  of  beet  sugar,  and,  as  we  were  a 
fat  importing  country,  we  soon  grew  short  of  fats. 
We  had,  therefore,  to  make  the  best  of  the  sugar,  and 
I  can  show  that  children  were  able  to  consume  large 
amounts  of  sugar  as  a  part  of  their  diet  without 
getting  loose  bowels  or  toothache.  One  has,  when 
giving  a  large  amount  of  sugar,  to  be  careful  to  give 
enough  protein  in  the  form  of  meats,  cheese,  or  milk. 


FEEDING  IN  THE  FIRST  YEAR  OF  LIFE 

You  will  recall  that  in  a  previous  chapter  we  said 
that  we  began  our  work  in  practice  by  watching  the 
spontaneous  intake  of  a  great  many  individuals  over 
long  periods,  and  that  we  compared  that  intake  with 
the  nutritional  surface  expressed  by  the  square  of  the 
sitting  height.  I  did  not,  however,  mention  that  the 
standard  of  the  intake  was  the  "hektonem."  In  this 
way  we  secured  sufficient  data  to  answer  the  question 
of  how  many  "decinems"  a  person  ingests  per  square 
centimeter  absorbing  surface  as  calculated  from  the 
sitting  height,  or  to  use  a  brief  expression,  how  many 
"decinemsiquas"  he  ingests. 

To  explain  the  term  "decinemsiqua"  we  may  take 
the  following  example:  A  child  of  50  cm.  sitting  height 
takes  1250  nems  in  his  daily  diet.  We  call  the 
square  of  the  sitting  height  siqua.  The  daily  intake 
of  1250  nems  equals  5  decinems  multiplied  by  siqua 
or,  briefly,  5  decinemsiquas. 

intake      1250  nems      1250      _  _  _  ,    . 

~= "  ~cn — zrT  =  oi?^  -  °5  nem  =  5  decinems 

siqua  50  x  50         2500 

1250  nems  (daily  intake)  =  5  decinems  x  2500  (siqua)  =  1250 
(daily  intake) 

By  registering  the  weight  of  the  body  daily  we 
could  observe  whether  the  amount  the  child  ingested 

35 


36    THE  PIRQUET  SYSTEM  OF  NUTRITION 

was  sufficient  to  maintain  his  weight,  or  whether  he 
gained,  and  how  much.  In  drawing  conclusions  we 
did  not  make  use  of  arithmetical  averages,  but  we  put 
down  a  point  for  each  observation  and  then  drew  lines 
through  these  points.  We  registered  a  point  weekly 
that  corresponded  to  the  change  in  weight  (abscissa) 
and  to  the  average  daily  intake  for  the  week  in  deci- 
nemsiquas  (ordinate).  Having  registered  the  records 
of  a  large  number  of  children,  a  graph  was  constructed 
by  drawing  a  line  through  the  field  of  all  the  points 
recorded.  This  method  prevented  us  from  being  too 
much  influenced  by  various  abnormalities. 

The  most  extensive  study  was  made  in  nurslings 
and  especially  in  newborn  children  (Vol.  II,  pages 
263  to  270).  The  results  of  the  experiments  led  us  to 
very  simple  practical  rules. 

We  distinguish  four  standard  amounts  in  quantita- 
tive feeding — the  maximum,  the  minimum,  the  aequum, 
and  the  optimum.  The  maximum  is  the  quantity  of 
food  that  a  normal  human  being  can  digest  within 
twenty-four  hours  without  impairing  his  health  and 
without  overtaxing  his  alimentary  canal.  This  maxi- 
mum is  about  1  nem  or  10  decinems  per  square  centi- 
meter of  the  square  of  the  sitting  height.  The 
maximum,  we  will  say,  is  then  about  10  decinemsiquas. 
Most  persons  left  to  themselves  never  attain  that 
limit  except  in  extraordinary  circumstances,  as,  for 
instance,  after  several  days  of  fasting.  The  minimum 
is   the  combustible  amount  necessary   to  keep   the 


FEEDING  IN  THE  FIRST  YEAR  OF  LIFE    37 

human  machine  going  and  to  maintain  the  body 
weight  in  a  condition  of  no  muscular  work  except 
that  of  chewing  and  digesting.  It  is  the  amount 
that  maintains  the  person  in  weight  if  he  lies  in 
bed  all  the  time.  This  amount  is  required  chiefly 
for  the  work  of  the  heart  and  lungs  and  for  that 
of  the  large  glands  (liver,  pancreas,  etc.).  This  mini- 
mum corresponds  to  about  3  decinemsiquas.  The 
cequum  is  the  amount  required  to  maintain  weight 
under  a  given  condition  of  activity.  Thus,  approxi- 
mately 1  decinemsiqua  more  than  the  minimum  is 
required  when  a  man  works  at  an  occupation  that  is 
entirely  sedentary  instead  of  lying  in  bed.  If  he  does 
some  walking  besides  sitting  at  his  desk  he  needs 
2  decinemsiquas  in  addition  to  the  minimum,  or  5 
decinemsiquas  altogether.  If  he  exercises  vigorously 
or  does  manual  labor  he  needs  additional  food-stuffs; 
for  a  very  hard  worker  the  aequum  may  become  identi- 
cal with  the  maximum,  for  he  then  does  all  the  work 
possible  with  the  intestinal  equipment  he  has.  Such 
a  man  becomes  a  machine  for  work  just  as  does  a 
horse  or  ox.  On  a  well-organized  farm  these  animals 
are  run  at  full  speed,  eating  their  maximum,  and 
doing  just  as  much  work  as  possible  without  loss  of 
weight.  The  optimum,  finally,  is  a  conception  which 
includes  a  judgment;  it  is  the  amount  of  food  that 
should  be  used  by  a  given  person.  In  a  case  of  heart 
disease  this  may  be  identical  with  the  minimum  if 
we  desire  to  keep  the  patient  in  bed  as  quiet  as  possi- 


38    THE  PIRQUET  SYSTEM  OF  NUTRITION 

ble  and  doing  as  little  digestive  work  as  possible.  In 
most  normal  adults  the  optimum  is  identical  with  the 
aequum,  for  our  object  is  simply  to  maintain  the  weight 
under  their  condition  of  work.  But  there  are  certain 
fat  or  thin  adults  whose  weight  we  desire  to  change. 
In  such  cases  the  optimum  will  be  1  or  2  decinem  less 
or  1  or  2  decinem  more  than  the  aequum.  In  children 
the  optimum  is  practically  always  larger  than  the 
sequum,  as  we  wish  them  to  grow;  hence,  we  add  at 
least  1  decinemsiqua  to  the  aequum.  The  full  amount 
then  provides  not  only  for  growth  in  length  but  also 
for  growth  in  fat  and  muscle. 

Let  us  take  an  example:  A  boy  of  eleven  years  with 
a  sitting  height  of  70  cm.  has  a  nutrition  surface  of 
70  by  70  =  4900  cm.  The  maximum  that  he  could 
digest  would  be  10  decinems  per  square  centimeter  or 
4900  nems.  The  minimum,  if  he  stays  in  bed  without 
moving  at  all  (for  a  healthy  boy  practically  impossi- 
ble), would  be  3  decinemsiquas,  4900  by  ^r  =  1470 
nems.  Though  he  sits  still  in  school  for  some  hours 
he  is  likely  to  be  very  active  during  the  rest  of  the  day. 
We  give  him,  therefore,  3  decinemsiquas  more  than  the 
minimum  in  order  to  maintain  his  weight;  that  is, 

6  dnsq.  per  day.  But  we  desire  not  only  to  maintain 
his  weight  but  also  to  provide  for  growth  and  gain  in 
fat  and  muscle,  so  we  give  him  say  1  dnsq.  more,  or 

7  dnsq.  (T7o  by  4900  =  3360)  in  all  as  an  optimum. 
How  should  the  child  take  this  amount?    We  must 

take  into  account  not  simply  the  daily  intake,  but 


FEEDING  IN  THE  FIRST  YEAR  OF  LIFE    39 

also  the  distribution  of  the  daily  feedings.    The  food 
is  best  utilized  when  given  at  regular  intervals  in  equal 
daily    amounts.     The   advantages    of    such    regular 
feedings  have  been  known  by  farmers  for  a  long  time. 
They  used  to  feed  their  milch  cows  the  same  amount 
three  times  a  day.    In  children  the  smaller  they  are, 
the  less  are  they  able  to  take  large  amounts  at  one 
time.    We  have,  therefore,  to  give  them  many  meals 
in  order  to  make  them  ingest  the  necessary  amount  of 
food.    Rules  have  to  be  laid  down,  therefore,  for  the 
division   of    the   optimum   amount  into  constituent 
meals.     In  a  newborn  baby  we  begin   with   eight 
feedings  at  intervals  of  three  hours— midnight,  3,  6, 
9  a.m.,  midday,  3,  6,  9  p.  m.    When  the  baby  is  a  few 
days  old  we  leave  out  the  midnight  meal  in  order 
to  give  the  child  a  longer  sleep  and  to  allow  the  mother 
more  rest.    After  a  fortnight  we  omit  the  feeding  at 
3  a.  m.,  and  then  only  six  feedings  remain  between 
6  a.  m.  and  9  p.  m.,  with  the  same  intervals  of  three 
hours.     This  rule  stands  for  the  whole  of  the  first  year 
of  life.     In  the  second  year  we  omit  the  feeding  at 
9  p.  m.  and  continue  throughout  the  rest  of  childhood 
to  give  five  feedings— three  main  meals,  morning,  mid- 
day, and  evening,  and  two  small  meals  in  the  middle 
of  the  forenoon  and  afternoon  respectively.    For  adults 
only  three  main  meals  are  necessary.    The  exact  times 
chosen  are  less  important  than  the  observance  of  in- 
tervals between  meals.     Thus,  if  we  give  breakfast 
at  7.30  instead  of  at  6  A.  m.,  we  may  postpone  each 


40    THE  PIRQUET  SYSTEM  OF  NUTRITION 

feeding  in  the  whole  schedule  for  an  hour  and  a  half. 
The  noon  meal  could  then  come  at  1.30  and  the  evening 
meal  at  7.30. 

Let  us  return  to  the  feeding  of  the  nursling  or  the 
newborn  baby.  Six  hours  after  delivery  we  put  the 
child  to  the  breast,  and  from  that  time,  at  intervals  of 
three  hours,  we  try  to  keep  the  child  breast  fed,  and 
for  some  days  we  watch  the  intake  of  milk  by  weigh- 
ing the  child  before  and  after  feeding.  If  the  breast 
milk  is  sufficient  we  leave  the  child  to  his  instinct  and 
control  only  the  number  of  feedings  and  the  intervals 
as  mentioned.  If  the  mother's  milk  is  not  sufficient,  or 
if,  for  one  reason  or  another,  the  mother  is  not  allowed 
to  feed  the  baby,  we  make  use  of  one  of  the  following 
substitutes: 

As  mentioned  in  the  last  lecture,  every  composition 
which  has  the  same  combustible  value  as  human  milk 
we  call  single  strength  nutriment  (nutrimentum  sim- 
plex). We  use  the  prefix  Si  to  indicate  this  order. 
An  example  is  Sibo,  where  bo  stands  for  bovinum 
(bovin  origin):  "Sibo"  =  Lac  simplex  bovinum.  This 
food  contains  200  nems  in  200  grams  and  is  composed 
thus: 

Grams.  Nems. 

Milk  (of  37  per  cent,  of  fat) 100  100 

Sugar  (cane-sugar) 17  100 

Water 83 

200  200 

If  the  children  are  very  apt  to  vomit,  they  gener- 
ally do  better  if  we  give  very  little  fluid;  we  therefore 


FEEDING  IN  THE  FIRST  YEAR  OF  LIFE    41 

have  to  give  the  food  in  higher  concentration.  We 
use  in  these  cases  a  double  nutriment:  Lac  duplex 
bovinum,  or  "dubo." 

Grams.  Nems. 

Milk 100  100 

Sugar 17  100 

These  117  grams  are  reduced  by  boiling  to  100  grams 
of  weight  and  contain  200  nems.  Each  gram,  therefore, 
contains  2  nems. 

Oftener  we  use  a  medium  between  simple  and  double 
nutriment  called  "sesquibo"  from  the  Latin  word  for 
one  and  a  half. 


Milk. 
Sugar . 


Grams. 

Nems. 

100 

100 

8.5 

50 

This  preparation  is  reduced  by  boiling  to  100  grams 
and  contains  150  nems. 

The  amount  of  food  allotted  depends  on  the  sitting 
height  of  the  baby.  If,  for  instance,  a  child  of  two 
months  of  age  has  a  sitting  height  of  35  cm.,  the 
formula  for  maximum  food  allowance  would  be 

!|j  X  Siqua  =  35  X  35  =  1225  nems. 

The  optimum  food  allowance  is  composed  of  3  dnsq. 
for  minimum  requirements,  1  for  body  movements,  1 
for  growth  in  length,  and  1  for  increase  in  weight, 
totalling  6  dsnq.  For  a  whole  day's  ration  1225  X  tu 
would  be  required;  for  each  of  the  six  equal  feedings 


42    THE  PIRQUET  SYSTEM  OF  NUTRITION 

1225  X  tg  or  122.5  nems,  roughly  120  nems.  Of 
"sibo"  the  child  would  have  to  take  120  grams,  of 
"dubo"  only  60  grams,  and  of  "sesquibo"  80  grams 
at  each  feeding. 

In  the  middle  of  the  first  year  of  life  we  begin  to 
substitute  more  solid  food  for  milk  at  the  noon  meal. 
The  first  semisolid  is  a  gruel  of  milk,  sugar,  and  flour, 
in  the  form  of  double  nutriment,  the  composition  of 
which  I  gave  in  the  last  lecture. 

At  nine  months  the  child  is  taught  to  eat  vegetables 
at  midday.  The  gruel  is  given  at  6  p.  m.  The  fol- 
lowing is  an  example  of  mashed  potatoes  prepared  as 
single  strength  nutriment: 

Nems. 

40  grams  of  mashed  potatoes 50 

50  grams  of  milk 50 

Water  sufficient  to  make  100  grams. 
(A  little  salt  is  added  to  accustom  the  baby  to  the  salty  taste.) 

From  now  on  every  month  some  new  thing  is  intro- 
duced, such  as  different  vegetables,  white  bread  soaked 
in  milk,  biscuits,  etc.  The  breast  meals  are  one  by 
one  replaced  by  other  feedings  in  such  a  way  that  at 
twelve  months  the  child  is  wholly  weaned.  During  the 
whole  second  year  the  education  of  the  child  to  take 
different  food-stuffs  continues.  We  call  this  process 
"the  nutrition  school."  The  baby  is  taught  at  this 
very  early  age  to  eat  small  quantities  of  almost  every- 
thing appropriate  for  the  child— bread  with  butter, 
jam,  eggs,  and  the  last  thing,  at  twenty-four  months, 
is  a  very  small  quantity  of  meat. 


FEEDING  IN  THE  FIRST  YEAR  OF  LIFE    43 


To  avoid  the  danger  of  getting  too  small  an  amount 
of  "fat-soluble  vitamin"  the  babies  during  the  winter 
season  get  a  teaspoonful  of  cod-liver  oil  daily,  which  is 
at  the  same  time  calculated  in  the  food  value  of  the 
diet: 

1  teaspoonful  =  5  grams  of  oil  X  nem  value  of  13 1  =  46f ,  or 
approximately  =  50  nems. 

The  babies  are  exposed  as  much  as  possible  to  sun  and 
open  air.  We  use  for  that  purpose  small  balconies  put 
in  the  windows  with  southern  exposure. 

We  have  not  sufficient  time  here  to  discuss  the 
treatment  of  premature  birth  and  malnutrition.  Let 
me  say  only  that  it  is  done  on  exactly  the  same  princi- 
ples. In  very  weak  premature  babies  we  begin  with 
one  extra  feeding  between  the  intervals  of  three  hours; 
that  is,  we  feed  them  sixteen  times  a  day  at  intervals 
of  one  and  a  half  hours.  In  malnutrition  we  lay  great 
stress  on  the  exact  registration  of  stools  and  vomiting. 
There  are  so  many  cases  where  an  apparent  malnu- 
trition is  caused  only  by  the  fact  that  the  baby  vomits 
a  good  part  of  the  day's  requirements.  A  baby  who 
vomits  and  has  at  the  same  time  a  normal  stool  or 
one  small  in  quantity,  is  not  to  be  considered  as 
having  " catarrh  of  stomach,"  for  this  kind  of  vomiting 
is  a  more  or  less  nervous  habit.  Nothing  could  be 
worse  than  to  dilute  the  food  for  such  a  baby;  on  the 
contrary,  the  necessary  amount  of  food  should  be  given 
in  a  more  concentrated  form,  either  as  a  fluid  of  * 'double 


44    THE  PIRQUET  SYSTEM  OF  NUTRITION 

strength  nutriment"  (dubo),  or  as  a  gruel.  Losses  by 
vomiting  have  to  be  substituted  by  giving  additional 
food.  The  calculations  are,  of  course,  based  on  the 
square  of  the  sitting  height. 

Diarrhea  in  babies  arises  from  different  causes;  in 
these  cases  we  usually  give  a  water  diet  for  twelve 
hours,  then  proceed  to  the  minimum,  and  slowly  go 
up  to  the  optimum. 

Barlow's  disease  (infantile  scurvy),  which  we  saw 
very  rarely  before  the  war,  was  very  frequent  during 
and  after,  probably  as  an  indirect  effect  of  Austria  be- 
ing cut  off  from  her  coal  regions.  This,  of  course, 
seems  to  be  a  very  remote  cause,  but  coal  is  necessary 
to  produce  artificial  ice  to  cool  the  milk.  When  the 
farmer  is  without  ice  he  is  tempted  to  use  various 
thermic  and  chemical  devices  to  keep  the  milk  from 
souring,  and  in  this  way  the  vitamins  are  destroyed. 

As  to  rickets,  the  effect  of  the  war  conditions  is  not 
so  clear.  Vienna  had  always  a  large  amount  of 
rickets,  and  although  most  of  the  physicians  in  child 
practice  got  the  impression  that  they  saw  a  much 
greater  amount  of  severe  rickets  during  and  after  the 
war,  statistical  proof  of  this  has  not  been  given.  Cases 
of  osteomalacia  as  a  consequence  of  hunger  were  very 
frequent  in  Vienna,  mostly  in  1919,  but  not  among 
children. 

Work  on  rachitis  in  America  and  England  in  recent 
years,  and  especially  the  investigations  carried  out  at 
the  University  Kinderklinik  in  Vienna    1921-22  by 


FEEDING  IN  THE  FIRST  YEAR  OF  LIFE    45 

Chick,  Dalyell,  and  Wimberger,  have  thrown  much 
light  on  the  etiology  of  rickets,  and  seem  to  make  the 
infection  theory  of  its  origin  superfluous.  Present 
knowledge  indicates  that  the  disease  results  from  the 
combined  effect  of  deficiency  in  the  diet  of  a  specific 
food  constituent  (vitamin)  and  lack  of  direct  sunlight. 
The  old  practical  rule  of  fighting  rickets  by  "Licht, 
Luft,  Leberthrahn" — air,  light,  cod-liver  oil — finds  a 
scientific  explanation  on  this  basis. 

In  infant  feeding  in  general,  the  important  changes 
introduced  by  this  system  of  nutrition  are  that  the 
food  given  has  a  much  higher  energy  value  than  has 
usually  been  allotted  for  infants,  and  that  food  is 
given  in  a  much  more  concentrated  form  than  has 
been  used  previously.  The  excellent  results  obtained 
by  Schick  with  his  special  "Dubo"  feeding  are  likely 
to  have  a  wide  influence  on  existing  pediatric  methods. 


NUTRITIONAL    TREATMENT    OF    TUBERCU- 
LOSIS 

We  consider  tuberculosis  a  nutritional  disease  in 
the  sense  that  the  germs  of  tuberculosis,  which  are 
contained  in  the  body  of  practically  every  adult 
inhabitant  of  a  city,  are  not  allowed  to  spread  and  to 
overwhelm  the  organism  so  long  as  this  is  in  a  good 
state  of  nutrition.  We  may  say  that  the  power  of  the 
cells  to  produce  antibodies  depends  on  a  certain  excess 
of  food.  We  have  no  specific  food,  no  certain  chemical 
substance,  which  protects  against  tuberculosis,  but  we 
know  that  good  appetite  for  various  kinds  of  food  and 
satisfaction  of  this  appetite  by  ample  meals  is  the 
best  preventive  and  the  best  cure. 

In  my  opinion,  all  the  cures  which  in  the  course  of 
time  have  been  advised  for  tuberculosis  culminate 
in  the  therapy  of  feeding.  The  patients  are  sent  now 
to  the  seashore,  now  to  the  mountains,  now  to  the 
desert,  now  into  a  warm  valley;  all  these  tuberculosis 
resorts  have  in  common  only  the  condition  that  the 
patients  receive  good  care  and,  under  the  influence  of 
change  of  scene  and  freedom  from  home  worries,  begin 
to  eat.  The  rest  cure  in  these  tuberculosis  resorts 
effects  a  conservation   of   energy,  while  exposure  to 

46 


TREATMENT  OF  TUBERCULOSIS         47 

sunshine  and  fresh  air  stimulates  the  appetite  and 
allows  an  increase  of  metabolism.  Change  of  loca- 
tion and  numerous  psychic  stimulants  may  be  dis- 
pensed with  if  a  definite  amount  of  food  is  pre- 
scribed and  if  the  patients  are  ordered  to  take  an 
open-air  cure  combined  with  suitable  rest  intervals. 
The  large  sanatorium  ward  for  100  children  on  the 
roof  of  my  clinic  in  the  midst  of  Vienna,  a  city  so 
notorious  for  tuberculosis,  furnishes  a  proof  of  my 
assertion.  The  children  remain  there  from  one-half 
to  one  year  or  more.  They  are  in  the  open  air  sum- 
mer and  winter,  night  and  day,  clad  in  the  daytime  to 
suit  the  temperature  and  well  covered  at  night.  The 
children  soon  become  accustomed  to  living  in  the  open. 
Only  during  the  cold  winter  nights  must  the  little  ones 
be  provided  with  hot-water  bottles.  The  children  are 
indoors  only  when  washing  or  bathing,  at  meals,  and 
at  school,  in  all  about  four  hours  of  the  twenty-four. 
In  summer  school  is  held  also  in  the  open  air.  The 
most  important  function  of  the  day  is  eating,  for  food 
is  given  as  a  medicine  against  tuberculosis,  not  a  cer- 
tain quality  of  food,  but  a  certain  quantity. 

How  do  we  proceed  to  prescribe  this  food?  Let  us 
first  consider  a  patient  who  comes  to  my  out-patient 
department.  Let  him  be  a  boy  of  seven  years,  pale, 
emaciated,  with  some  swollen  glands,  and  a  history  of 
frequent  attacks  of  colds.  The  first  thing  I  do  is  to  make 
a  skin  test  and  order  a  Roentgen  photograph.  After 
two  days  he  returns  showing  a  positive  test  and  the 


48    THE  PIRQUET  SYSTEM  OF  NUTRITION 

Roentgen  plate  shows  an  enlargement  of  the  bronchial 
glands.  Conditions  at  home  might  be  favorable  for  feed- 
ing and  open-air  cure,  and  I  make  out  an  individual  pre- 
scription for  food.  I  take  his  height  and  his  weight  to 
determine  how  many  kilograms  he  is  under  weight  and 
whether  his  height  corresponds  to  his  age.  Then  I 
take  his  sitting  height,  and  find  out,  comparing  it 
on  a  chart  with  his  weight,  the  pelidisi.  The  sit- 
ting height  is  64  cm.,  the  weight,  19  kilograms;  the 
pelidisi,  therefore,  would  be  90.  He  is  about  3  kg. 
underweight.  His  food  requirement  will  consist  of 
3  decinemsiquas  as  the  basic  minimum,  with  allowance 
of  2  for  muscular  movements  (partial  rest  cure),  2  for 
gain  in  length  and  weight,  altogether  7  decinemsiquas. 
For  the  whole  day  he  gets,  therefore,  64  x  64  x  T70  = 
2860.2  n.  We  usually  put  the  requirement  for  pur- 
poses of  convenience  at  a  round  number,  viz.,  the 
nearest  multiple  of  500,  in  this  instance,  3000  nems  or 
30  hektonems  per  day;  of  them,  3  hektonems  are  given 
at  the  9  o'clock  meal,  2  in  the  afternoon  at  3 
o'clock,  and  the  remaining  25  are  divided  between  the 
three  main  meals,  6  a.  m.,  noon,  and  6  P.  m., 
which  equal  8,  9,  and  8  hektonems  respectively. 

A  schedule  is  made  for  the  time  and  the  amount  of 
the  feeding.  In  case  it  should  be  more  convenient  for 
the  mother  to  start  the  day  at  7  o'clock,  we  arrange 
meals  at  7  a.  m.,  10  a.  m.,  1  p.  m.,  4  p.  m.,  and  7  p.  m. 
We  give  the  biggest  meal,  9  hektonems,  at  noon. 


TREATMENT  OF  TUBERCULOSIS    49 


Time 

of 
meal. 

is 

**  c 

4>  C 

E 

Amount  in  grams  of  each  food. 

7 

8 

100 
milk 

100 
milk 

17 

sugar 

30 

bread 

8.5 
but- 
ter 

30 

bread 

20 

ham 

30 

jam 

A*  M. 

300  c.c.  water  and 
coffee 

10 
A.  M. 

3 

100 
milk 

30 

bread 

40 

(one) 
egg 

1 
P.  M. 

9 

20 

flour 

7.5 
fat 

40 
meat 

40 
meat 

80 
pota- 
toes 

50 

green 
peas, 

4  but- 
ter, 
and 
46 

water 

30 
bread 

20 

cheese 

150 

apple 

200 

soup 

4 
P.  M. 

2 

100 
milk 

20 

biscuit 

7 

P.  M. 

8 

20 

flour 

20 

flour 

20 

flour 

100 
milk 

17 

sugar 

30 
bread 

8.5 
but- 
ter 

20 

honey 

200,  baked  after  recipe 

1             1             1             1 

This  gives  an  idea  how  a  day  has  to  be  arranged. 
There  is  a  book  of  recipes  where  the  mother  finds 
variation  for  eight  different  days  (System  der  Er- 
nahrung,  Vol.  III). 

In  the  same  schedule  we  take  into  account  the 
protein.  We  count  the  dekanems  of  protein  contained 
in  every  hektonem. 


50    THE  PIRQUET  SYSTEM  OF  NUTRITION 

Dekanems  of  Protein  Contained  in  Every  Hektonem  of  Food,  see  p.  31. 


2 
milk 

2 
milk 

0 
sugar 

1 
bread 

0 
butter 

1 
bread 

3 
ham 

0 
jam 

-     9 

2 
milk 

1 
bread 

3 
egg 

«     6 

1 

flour 

0 
fat 

4 
meat 

4 

meat 

0.5 

potatoes 

1 

green 

peas 

and 

butter 

1 

bread 

4 
cheese 

0.5 
apple 

-  16 

2 
milk 

1 

cakes 

-     3 

1 
flour 

1 
flour 

1 

flour 

2 
milk 

0 
sugar 

1 
bread 

0 
butter 

0 

honey 

=     6 

Total. 

....40 

This  gives  40  dekanems  of  protein  in  30  hektonems 
of  food;  this  falls  between  the  minimum  of  10  per  cent. 
(30  dekanems)  and  the  maximum  of  20  per  cent, 
protein  (60  dekanems),  and  meets,  therefore,  the  re- 
quirement. 

Water  Contained  in  the  Food  (Weight  of  Food,  see  p.  S3). 


300 
milk  and  coffee 


30 


8.5 


30 


20 


30 


Weight, 

grams. 

418.5 


100 

30 

40 

170 

40 

40 

80 

100 

30 

20 

150 

200 
soup 

660 

100 

20 

120 

200 

30 

8.5 

20 

258.5 

Total. 

...1622 

TREATMENT  OF  TUBERCULOSIS    51 

In  order  to  know  the  total  amount  of  water  we 
figure  the  weight  of  all  the  dishes  on  the  above  form. 

The  whole  day's  food  is  3000  nems  in  1628  grams, 
therefore  about  "double  strength  nutriment,"  which 
means  rather  dry  food;  400  grams  of  water  taken  at 
noon  or  evening  will  bring  this  ration  on  our  usual 
average  of  water  intake. 

The  feeding  cure  is  combined  with  a  rest  cure.  The 
child  is  left  in  bed  on  a  porch,  in  a  garden,  or  on  a 
roof-garden  for  the  first  two  weeks,  then  allowed  to 
get  up  half  an  hour  in  the  morning  and  in  the  after- 
noon for  the  next  week,  and  after  that  is  gradually 
left  out  of  bed  for  more  and  more  time.  The  body 
weight  is  taken  once  a  week.  If  in  later  weeks  the 
gain  is  not  sufficient,  we  may  go  to  8  dnsq.,  adding 
3  hektonems,  i.  e.,  one  hektonem  to  each  of  the  three 
chief  meals,  giving,  for  instance,  an  additional  cake  of 
20  grams  at  each  main  meal. 

In  an  institution  where  we  have  many  children  it 
would  be  loss  of  time  to  compose  a  menu  for  each. 
We  simplify  matters  then  by  making 

Nutrition  Classes 

In  a  ward  containing  children  affected  with  slight 
tuberculosis  and  convalescents  from  an  acute  attack 
of  tuberculosis  we  put  all  on  a  diet  of  7  dnsq.  and 
differentiate  the  amounts,  depending  on  the  sitting 
height  of  the  children. 


52    THE  PIRQUET  SYSTEM  OF  NUTRITION 


Sitting 
height, 

Hn. 
per  day. 

Nutrition 
class. 

6  a.  m. 

— Hektont 
9  a.  m. 

:ms  at  ea< 
Noon 

ch  meal- 

2  P.  M. 

6  P.  u 

cm. 

52-56 

20 

II 

5 

3 

5 

2 

5 

57-62 

25 

Ha 

6 

3 

7 

2 

7 

63-67 

30 

III 

8 

3 

9 

2 

8 

68-73 

35 

Ilia 

10 

3 

10 

2 

10 

74-77 

40 

IV 

11 

3 

12 

2 

12 

78-82 

45 

IVa 

13 

3 

14 

2 

13 

83-86  50  V  15  3  15  2        15 

The  children  are  seated  at  table  according  to  the 
class  to  which  they  belong,  as  measured  by  their  nu- 
tritional requirements.  The  food  is  distributed  by 
means  of  a  graduated  dipper  for  the  fluids  and  a 
balance  for  the  solids.  Bread  and  cakes  are  sliced  be- 
forehand in  hektonem  portions.  In  this  way  it  is  very 
easy  to  make  the  children  eat  all  their  portions;  nothing 
is  allowed  to  be  left.  The  children  have  to  remain 
at  the  table  until  all  is  eaten.  No  remnants  are 
permitted.  This  results  in  great  economy.  No  food 
is  turned  into  garbage.  When  this  system  was  intro- 
duced the  man  who  rented  the  right  of  removing  the 
garbage  wanted  to  sue  us  because  he  fell  short. 

The  whole  day  is  divided  into  a  schedule  which  is 
strictly  adhered  to: 

5.45  Hour  for  rising  (the  children  are  required  to  void) . 

6.00  Breakfast. 

6.45  Inspection  of  mouth  and  throat  by  the  nurse. 

7.00  Cleansing  of  mouth  and  teeth,  washing,  combing 

the  hair. 


TREATMENT  OF  TUBERCULOSIS    53 

8.00  to  10.00    School  in  four  classes: 

(a)  Kindergarten. 

(b)  Lowest  class  of  elementary  school. 

(c)  Second  class  of  elementary  school. 

(d)  All  higher  classes. 
9.00                  Second  meal. 

10.00  to  11.45  Rest  cure  (in  bed  on  roof  garden),  medical  inspec- 
tion and  treatment. 

11.45  Washing  the  hands. 

12.00  Noon  meal. 

1.00  The  children  are  required  to  void. 

1.30  to    3.00  Rest  cure. 

3.00  Afternoon  meal. 

4.00  to    6.00  Play  or  school. 

5.00  Washing  and  treatment  of  skin  infections. 

6.00  Evening  meal. 

7.00  Voiding. 

7.30  Bed. 

Friday  is  set  apart  as  a  bathing  day  for  all  the 
children;  there  is  no  school  on  this  day.  On  Saturday 
the  children  are  weighed,  and  a  record  is  made  of  the 
weight.  This  record  shows  at  a  glance  which  children 
have  or  have  not  gained.  The  reason  for  failure  to 
gain  must  be  noted  in  the  table — vomiting,  infections 
of  the  upper  respiratory  tract,  etc. 

The  increase  in  weight  of  malnourished  children 
on  such  a  diet  is  usually  very  great  in  the  first 
month,  and  after  that  lessens  slowly.  A  kind  of  an 
equilibrium  is  reached  between  the  intake  and  the 
amount  of  reserve  substances  in  the  body.  Dr. 
Therese  Zillich  made  a  special  study  of  this  question. 


54    THE  PIRQUET  SYSTEM  OF  NUTRITION 

She  showed  that  most  of  the  children  fed  on  7  dsnq. 
reached  a  pelidisi  of  94,  whereas  children  fed  on  6  dnsq. 
reached  91.5,  and  those  fed  on  only  5  dnsq.  did  not 
have  a  higher  average  than  89.    From  these  data  we 
may  draw  conclusions  concerning  the  amount  of  food 
a  child  has  been  given  if  we  know  his  pelidisi.    If  the 
children  in  a  boarding  school  have  an  average  pelidisi 
of  94,  we  may  draw  the  conclusion  that  the  average 
intake  is  7  dnsq.  on  condition  that  the  bodily  exericse 
is  not  much  different  from  bodily  exercise  of  the  chil- 
dren of  our  experiments.    If,  on  the  other  hand,  the 
children  have  an  average  of  91,  it  means  that  they 
received  less  than  6  dnsq.    The  477  children  accepted 
in  the  year  1919  at  Mitterndorf,  a  country  home  in 
connection  with  my  hospital,  showed  an  average  of 
only  89  pelidisi.     This  figure  clearly  indicates  the  de- 
fective nutrition  during  this  worst  period  of  Austria's 
struggle.     From  May  1,  1917  to  May  1,  1918  the 
average  gain  of  the  children  on  my  roof-garden  was 
11.27  kg.;  in  later  years  it  was  somewhat  less  due 
to  the  fact  that  the  condition  of  the  children  was 
better  at  the  time  when  they  were  accepted.    A  child 
of  school  age  gains  under  normal  conditions  about 
2.5  kg.  a  year;  the  average  gain  of  our  children  was, 
therefore,  more  than  four  times  the  normal  gain  in 
weight  for  healthy  children  of  corresponding  age  under 
normal  conditions.    This  enormous  increase  in  gain  has 
its  explanation  partly  in  the  poor  condition  of  the  chil- 
dren at  the  time  of  their  acceptance.    Another  factor 


TREATMENT  OF  TUBERCULOSIS    55 

which  must  be  taken  into  consideration  is  that  the 
majority  of  children  did  not  stay  the  whole  year,  but 
left  the  hospital  when  they  had  gained.  But  the 
excessive  gain  shows  one  thing — that  our  feeding 
methods  worked  well  in  practice  and  that,  at  a  mini- 
mum of  expense,  the  children  gained  well  in  weight. 
The  total  average  expense  per  capita  in  1917  was 
2.54  kronen,  or  less  than  50  cents.  Of  the  allowance 
of  5  kronen  per  child  we  saved  about  one-half.  The 
diet  used  was  very  simple.  I  do  not,  as  I  previously 
said,  believe  that  any  particular  food  is  necessary  for 
the  treatment  of  tuberculosis.  The  children  received 
meat  only  once  a  week.  The  greater  part  of  the  food 
consisted  of  flour,  milk,  potatoes,  and  sugar.  The 
protein  average  ran  close  to  10  per  cent.  In  this  last 
half  year  we  made  an  extensive  experiment  concerning 
fat  requirements  in  the  diet.  One-half  of  the  children 
were  given  a  diet  rich  in  fats;  the  other  half  was  given 
a  diet  of  the  same  nutritive  value  which  was  poor  in 
fats.  The  result  showed  not  the  slightest  difference 
between  the  two  groups  either  in  respect  to  the 
average  gain  or  the  progress  of  the  tuberculosis. 

For  an  institution  like  a  tuberculosis  sanatorium  in 
which  most  of  the  children  come  from  poor  families, 
and  especially  in  a  country  like  Austria  where  the 
whole  population  is  impoverished,  it  is  very  impor- 
tant to  make  the  hospital  diet  inexpensive.  It  may 
do  in  an  acute  illness  to  "feed  up"  the  child  with  eggs 
and   white   meat.     Tuberculosis,   however,   lasts   for 


56    THE  PIRQUET  SYSTEM  OF  NUTRITION 

years.  The  tenacity  for  the  spread  of  infection  from  a 
tuberculous  focus  lasts  certainly  much  longer  than  the 
duration  of  the  child's  stay  in  the  hospital.  If  we 
should  spoil  the  child  with  nice  and  tasty  food,  the 
result  would  be  that  he  would  no  longer  want  the 
poor  food  he  received  at  home.  In  a  short  time  all 
the  gain  in  weight  obtained  at  the  hospital  would  be 
lost.  We  saw  hundreds  of  instances  of  this  among  the 
Austrian  children  who  were  taken  after  the  war  by 
Swiss  and  Dutch  friends  for  a  stay  of  six  or  eight 
weeks  in  the  prosperous  countries  of  Switzerland  and 
Holland.  On  the  other  hand,  children  who  became 
accustomed  to  the  simple  diet  in  my  hospital  and,  most 
important  of  all,  learned  to  eat  everything  which  was 
set  before  them,  became  "educated  eaters"  and  con- 
tinued to  eat  in  their  homes. 

As  to  the  results  of  our  feeding  method  in  tuber- 
culosis, I  may  say  that  we  are  extremely  well  satis- 
fied. Having  proved  that  method,  we  gradually  for- 
got about  all  other  methods  of  cure.  We  do  not 
use  tuberculin  treatment  any  more,  though  we  were 
very  fond  of  it  before.  We  do  not  use  any  other 
specific  medical  treatment.  Our  prognosis  in  a  case 
of  tuberculosis  becomes  more  and  more  optimistic. 
We  used,  for  instance,  to  consider  pulmonary  tuber- 
culosis in  the  case  of  girls  between  the  ages  of  eleven 
and  fourteen  years  as  almost  fatal;  now  we  see 
many  recoveries.  Our  greatest  pride  is  in  the  results 
obtained  from  treatment  of  children  suffering  from 


TREATMENT  OF  TUBERCULOSIS    57 

tuberculoma  of  the  brain.  I  will  call  attention  espe- 
cially to  the  case  of  one  boy  who  suffered  severe 
epileptic  attacks  and  presented  symptoms  of  cerebral 
pressure.  The  diagnosis  of  a  tuberculous  brain  tumor 
had  been  established  as  far  as  was  possible  in  the 
living  subject.  The  treatment  was  conducted  at  my 
clinic  from  January  to  November,  1918,  and  was  con- 
tinued at  home  by  the  mother.  The  treatment  re- 
sulted in  a  perfect  cure.  I  saw  him  on  the  last  occa- 
sion in  the  spring  of  1921,  when  he  was  healthy  and 
vigorous  and  mentally  perfectly  normal.  There  is  no 
reason  why  a  tubercle  in  the  brain  should  not  be  as 
readily  curable  as  tubercles  in  other  organs  which,  as 
we  all  know,  are  susceptible  to  cure.  The  chief  diffi- 
culties to  overcome  in  such  a  case  are  the  tendencies 
to  nausea  and  vomiting  and  lack  of  appetite.  These 
symptoms  are  controlled  only  by  an  exact  regulation 
of  the  quantity  of  food,  combined  with  skill  and 
scrupulous  exactness  in  administration  of  food. 


PROPER  FEEDING  AS  PREVENTIVE 
MEDICINE 

Up  to  recent  years  the  science  of  nutrition  has 
been  rather  neglected  by  the  clinician.  When  I  was  a 
student  I  learned  a  little  about  calories  in  the  physi- 
ology class,  but  I  had  no  scientific  idea  about  the 
practice  of  feeding.  Up  to  now  there  are  only  a  few 
places  where  this  latter  subject  has  been  attempted. 
It  is  an  easy  thing  to  teach  the  fundamental  principles 
about  food  values  and  all  that,  but  the  chief  problem 
is  to  make  a  cook  or  a  grandmother  believe  in  the 
practice  of  scientific  feeding.  It  is  one  thing  to  pre- 
scribe a  medicine  and  another  thing  to  prepare  it. 
We  may  have  some  idea  how  a  prescription  should  be 
compounded,  but  most  of  us  would  be  lost  without  a 
pharmacist  to  do  it.  The  pharmacist  gets  a  scientific 
training  in  order  to  be  educated  to  perform  his  work 
with  scrupulous  accuracy  and  to  understand  what  he 
does;  and  the  same  should  be  done  with  the  cook. 
In  Austria  nurses  have  looked  down  on  cooking  as  an 
art  much  inferior  to  nursing.  Since  I  take  my  best 
nurses  for  superintending  the  kitchen  and  since  I 
declare  that  the  kitchen,  for  me,  is  more  impor- 
tant than  the  pharmacy,  I  find  a  wonderful  co-opera- 
tion. 

58 


FEEDING  AS  PREVENTIVE  MEDICINE     59 

Feeding,  indeed,  is  the  most  valuable  thing  in  the 
hands  of  the  doctor  if  you  only  think  of  tuberculosis. 
This  is  the  great  disease  of  childhood.  Most  of  the 
serious  complaints  in  school  age  come  from  it;  and  we 
can  cure  it  with  proper  feeding.  Rickets  and  Bar- 
low's disease  have  also  a  close  connection  with  feeding, 
and  the  cure  of  typhoid  and  dysentery  are  mostly 
dependent  on  quantitative  feeding,  not  to  speak  of 
the  other  tribulations  of  the  first  year  of  age,  which, 
to  about  50  per  cent.,  result  from  improper  feed- 
ing. 

But  we  are  not  only  curing  disease,  we  are  pre- 
venting it  with  the  correct  feeding.  We  avoid  malnu- 
trition of  the  baby,  we  avoid  Barlow's  disease,  and  we 
avoid  the  serious  forms  of  tuberculosis  if  we  keep  the 
children  in  a  constant  good  state  of  nutrition.  For 
this  reason  proper  feeding  can  be  ranked  among  the 
best  means  of  preventive  medicine. 

But  in  order  to  make  it  so  effective  that  real  statis- 
tical results  can  be  obtained  we  cannot  be  satisfied  if 
proper  feeding  principles  be  applied  to  individuals  or 
to  a  small  group  of  people.  We  must  try  to  make  the 
science  of  nutrition  a  part  of  the  education  of  the 
people  at  large;  everybody  should  know  about  it, 
every  individual  should  partake  of  the  privileges  of 
this  science. 

The  science  of  nutrition  is  based  on  quite  a  number 
of  other  sciences.     It  uses: 


60    THE  PIRQUET  SYSTEM  OF  NUTRITION 

(a)  Chemistry,  general  and  analytical  chemistry  of 
food-stuffs. 
Biochemistry. 
Chemical  technology. 
{b)  Botany,  systematic  and  descriptive: 
Physiology  of  plants. 
Geography  of  plants. 

(c)  Zoology. 

(d)  Minerology. 

We  have  to  consider,  furthermore, 

(e)  Comparative  science  of  nutrition. 

(/)  Physiology  of  nutrition  and  most  of  the  other 
chapters  of  physiology. 

We  considered  in  a  former  lecture  the  food-stuffs 
only  according  to  their  nutritive  value  and  according 
to  their  content  of  protein.  If  we  study  them  we  have 
to  bring  whatever  we  use  in  our  kitchen  into  a  system- 
atic order.  We  distinguish  nine  groups  of  food-stuffs 
and  appliances: 

1.  Milk  and  cheese. 

2.  Meat  and  preparations  from  meat. 

3.  Egg  and  albumen  preparations. 

4.  Fat  and  seeds  containing  fat,  for  instance,  lin- 

seed. 

5.  Flour  and  seeds   containing  carbohydrates,  for 

instance,  wheat. 

6.  Sugar  and  fruits. 

7.  Vegetables  (potatoes,  beets,  green  vegetables). 

8.  Spices. 


FEEDING  AS  PREVENTIVE  MEDICINE    61 

9.  Various  accessories  and  utensils  of  the  kitchen, 
for  instance,  refrigerator,  ovens,  etc. 

Concerning  all  the  food-stuffs  we  have  to  heed  the 
principal  data  which  the  sciences  above  mentioned 
have  brought  to  our  knowledge.  There  is,  I  think, 
also  the  training  of  the  American  dietitian.  What  we 
add  to  it  is  the  calculation  in  nems. 

The  housekeeper  has  to  buy — for  a  family  or  a 
larger  body  in  moderate  circumstances— the  necessary 
amount  of  food  at  a  minimum  price.  If  the  majority 
of  housekeepers  of  a  country  know  what  is  worth- 
while buying  they  will  regulate  the  market  and  a 
great  saving  for  the  whole  community  will  result.  In 
a  poor  country  like  Austria  this  is  very  important,  as 
it  means  that  our  people  will  be  able  to  eat  more  at 
the  same  cost.  Our  people,  for  instance,  have  the  idea 
that  meat  is  an  extremely  valuable  thing,  and  they 
deprive  themselves  of  other  food  in  order  to  eat  meat. 
Meat,  in  fact,  is  not  at  all  necessary,  and,  for  a  densely 
inhabited  country,  is  very  expensive  because  an  animal 
like  a  pig  needs  a  great  amount  of  food  which  could  be 
used  for  human  beings  as  well.  Of  6  units  of  food 
consumed  as  fodder  the  pig  gives  back  only  one  single 
unit  in  the  form  of  meat  or  lard.  If  a  poor  man  eats 
6  units  in  the  form  of  potatoes,  he  is  so  much  better 
off  than  eating  the  one  value  in  the  form  of  meat,  and 
if  the  majority  of  the  population  thinks  that  way  the 
farmer  will  sell  the  potatoes  at  a  greater  profit  than  he 
could  obtain  from  selling  the  pig.     This,  of  course, 


62    THE  PIRQUET  SYSTEM  OF  NUTRITION 

does  not  apply  to  a  country  like  America,  which  is 
overflowing  with  fodder  for  animals.  You  do  not  know 
what  to  do  with  your  surplus  of  corn,  and  fat  produc- 
tion by  the  way  of  the  pig  is  a  very  sensible  thing. 

The  greatest  prevention  we  are  able  to  exercise 
through  proper  feeding  is  the  prevention  of  stunted 
growth  and  muscular  weakness.  Growth  is  de- 
pendent on  two  factors:  heredity  and  proper  care  of 
the  child.  In  hundreds  of  instances  of  daily  life 
children  grow  taller  than  their  parents  if  they  are 
well  cared  for,  have  always  a  sufficient  amount  of 
proper  food,  and  are  given  the  opportunity  for  exercise. 
On  the  other  hand,  in  a  family  with  tall  ancestors, 
one  or  the  other  child  may  stay  small  and  feeble. 
If  you  go  into  the  history  of  the  case  you  usually  find 
that  this  child  had  no  appetite,  and  the  parents  did 
not  insist  on  the  child's  eating  because  they  thought 
that  eating  in  the  absence  of  appetite  did  not  help. 
This  idea  is  entirely  wrong.  The  appetite  aids  diges- 
tion. Digestion  takes  place  more  rapidly  if  the  appetite 
is  intense,  but  assimilation  also  takes  place  if  appetite 
is  lacking,  and  the  combustion  in  the  muscles  or  the 
growth  in  length  and  in  fat  tissue  take  place  just  as 
well  from  a  food  which  has  been  eaten  because  of  a 
desire  for  it  as  from  food  taken  when  all  desire  is 
absent.  You  all  know  about  an  instance  of  this  law 
in  feeding  geese.  The  fowls  have  to  digest  much  more 
food  than  is  necessary  and  at  the  same  time  they  are 
prevented   from   running   about   and   dispensing   the 


FEEDING  AS  PREVENTIVE  MEDICINE    63 

surplus  in  muscular  action.    The  consequence  is  that 
they  get  very  fat. 

In  rearing  animals  the  farmers  have  appreciated  for 
a  long  time  all  these  rules  much  better  than  the  city 
people  have  realized  them  in  the  care  of  their  children. 
The  farmers  know,  for  instance,  that  a  long  period  of 
food  scarcity  affects  growth  so  much  that  the  animals 
are  stunted  for  lifetime.  This  is  the  case  now  with 
millions  of  young  human  beings  in  Europe.  But  there 
is  one  advantage;  the  period  of  growth  in  man  lasts 
so  much  longer  than  in  animals,  and  an  undernourish- 
ment of  one  or  two  years  can  be  overcome  in  its  conse- 
quence if  we  are  able  to  feed  amply  during  the  rest  of 
childhood. 

One  of  my  assistants,  Dr.  Kassowitz,  made  a  study 
of  children  in  a  home.  All  came  in  in  a  very  poor 
state  of  nutrition  and  their  average  height  was  a  great 
deal  below  the  normal  for  the  age  of  the  child.  By 
feeding  them  quantitatively  through  six  years  these 
children  not  only  became  heavier  than  so-called  nor- 
mal children,  but  their  average  height  also  surpassed 
the  normal. 

When  American  feeding  started  in  Austria  the  chil- 
dren of  fourteen  years  were  several  centimeters  below 
the  normal  in  height.  We  made  a  special  study  of  sev- 
eral thousand  apprentices  who  received  American  food. 
With  these  additional  meals  they  began  to  grow  again 
twice  as  fast  as  the  normal  rate  of  growth  for  that 
age;  and  if  we  are  able  to  continue  having  them  fed 


64    THE  PIRQUET  SYSTEM  OF  NUTRITION 

they  will  reach  normal  size  just  in  time,  for  after 
puberty  is  reached  the  ability  to  grow  diminishes 
rapidly. 

Feeding  as  a  preventive  measure  against  the  effects 
of  food  scarcity  must  be  used  on  a  very  large  scale, 
and  for  that,  methods  of  mass  feeding  must  be 
developed.  They  include  the  methods  of  building  and 
organizing  large  kitchens,  bookkeeping  in  food  values, 
and  various  methods  of  inspection  and  control.  I 
cannot  here  go  into  the  details  of  organizing  a  kitchen, 
as  this  is  a  science  in  itself,  but  I  may  give  you  an 
idea  about  making  a  "budget"  in  terms  of  food  values. 

Let  us  take,  for  an  example,  a  summer  home  opened 
for  600  children.  It  is  a  farm  with  40  cows.  The  only 
food-stuffs  available  on  the  place  are  20  metric  tons 
(about  4400  pounds)  of  potatoes  and  the  same  amount 
of  green  vegetables.  Everything  else  has  to  be  brought 
from  the  city.  How  much  will  be  needed  for  a  stay 
of  two  months? 

You  will  have  to  state  your  needs.  The  children 
on  an  average  of  eleven  years  need  35  hektonems  a  day. 
You  will  need  for  these  children  about  60  adults,  with 
50  hektonems  a  day.  We  will  need  24,000  hektonems 
or  2400  kilonems  a  day.  We  stay  there  two  months; 
therefore  we  will  need  2400  X  60  =  144,000  kn.  or 
144  tonnenems. 

Now  we  have  to  figure  out  how  much  food  we  find 
there  and  how  much  we  will  have  to  import.  A  cow 
yielding  an  average  amount  of  milk  may  be  figured 


FEEDING  AS  PREVENTIVE  MEDICINE    65 

with  10  liters  of  milk  (a  liter  is  about  a  quart)  or  10 
kilonems  a  day.  60  days  X  10  kn.  X  40  cows  =  24,000 
kn.  Twenty  metric  tons  of  potatoes  are  20,000  kilo- 
grams.    A  kilogram  of  potatoes  contains  1.25  kilonem. 

Food 
Weight,     Nem    value,     Prot.        Prot. 
kilograms,  value.       kn.      value,    hektonems. 

Milk 24,000  1  24,000  2  48,000 

Potatoes 20,000  1 .  25  25,000  K  12,500 

Green  vegetables 20,000  0.4  8,000  2  16,000 

Meat 2,000  2.5  5,000  4  20,000 

Flour  for  bread 6,000  5  30,000  1  30,000 

Beans 500  4  2,000  2  4,000 

Sugar 1,000  6  6,000  0  0 

Fat 1,000  13  i  13,330  0  0 

White  flour 4,000  5  20,000  1  20,000 

Cocoa 1,000  6  6,000  1  6,000 

Cheese 1,000  5  5,000  4  20,000 

144,330  176,500 

The  144,330  kilonems  contain  176,500  hektonems  in 
the  form  of  protein;  this  is  between  10  and  20  per  cent., 
therefore  right. 

Another  kind  of  a  budget  is  to  be  made  if  we  get  a 
certain  amount  of  food-stuffs  for  a  given  period  and 
have  to  determine  how  many  people  we  are  able  to 
feed  with  it. 

Let  us  say  that  a  relief  administration  would  fur- 
nish the  following  consignment  for  a  month  for  the 
children  of  a  town: 


66    THE  PIRQUET  SYSTEM  OF  NUTRITION 

Nem 
value  of 
Metric  Article.  Nem  value       article  in 

tons.  per  gram.      tonnenems. 

150    Flour 5  750 

50    Sweet  condensed  milk 5  250 

50    Evaporated  milk 2  100 

40    Beans 4  160 

30    Cocoa 6  180 

30    Rice 5  150 

30    Bacon 10  300 


1890 


The  total  nem  value  is  1890  tonnenems.  The  stand- 
ard meal  for  children  is  one  kilonem;  this  makes 
1,890,000  meals.  A  month  has  25  weekdays;  76,600 
children,  therefore,  could  get  one  meal  on  every 
weekday.  Accordingly  we  would  have  to  choose  this 
number  of  children  for  the  meals. 

In  this  town  184,000  children  would  have  been 
examined  in  the  pelidisi  classification  and  would  have 
shown  the  following  figures: 

Pelidisi 89    90    91    92    93    94    95  and  more 

Children  (thousands)...   19     24    27    31     28     25    30 

S i  4 

70 

We  would  take,  after  the  pelidisi  examination,  the 
groups  89,  90,  and  91  pelidisi,  which  make  70,000 
children;  for  the  rest  of  the  7600  children  we  would 
pick  out  those  from  the  higher  pelidisis  by  a  medical 
examination  called  the  "sacratama"  method. 


FEEDING  AS  PREVENTIVE  MEDICINE    67 

Now  we  would  have  to  plan  six  different  meals  for 
each  day  of  the  week  out  of  the  given  food-stuffs. 
Each  meal  must  contain  1  kilonem  food  value,  must 
be  appetizing,  and  must  be  suitable  for  the  cooking 
facilities,  kettles,  and  ovens  of  our  kitchens.  This 
means  consideration  of  the  dishes  which  are  given  in  a 
boiled  or  in  a  baked  form. 

You  see  how  the  science  of  nutrition  can  be  applied 
to  the  single  individual,  to  a  group  of  people,  as  well  as 
to  feeding  on  the  largest  scale.  The  knowledge  of  this 
science  will  help  humanity  to  cure  individual  disease 
and  to  prevent  the  worst  plagues  of  humanity — body 
weakness  and  tuberculosis. 


BIBLIOGRAPHY 


Ambro2i£,  Matija  and  Rach,  Egon:    Grundriss  der  Diatverord- 

nungslehre  in  der  Padiatrie  nach  dem  Pirquet'schen  System. 

Leipzig  and  Wien,  Franz  Deuticke,  1921. 
Ambrozic,  M.:   Der  Nahningsbedarf  beim  Myxodem.    Ztschr.  f. 

Kdh.,  29,  1921, 117. 
Aron,  Hans:    t)ber  den  "Nahrwert"  und  die  Bedeutung  der 

Nahrungsfette.    Biochem.  Ztschr.,  Bd.  103,  1920,  172. 
Behm-Heuberg:  Referat  iiber  das  "Lehrbuch  der  Volksernahrung 

nach  dem  Pirquet'schen  System"  von  E.  Mayerhofer  und 

C.  Pirquet,  Arch.  f.  Kdh.,  68,  1921,  491. 
British  Medical  Journal,  October  30,  1920,  606:    The  "Nem" 

System  of  Nutrition. 
Carter,  William:   The  Pirquet  System  of  Nutrition  and  its  Ap- 
plicability to  American  Conditions,  Journ.  of  the  Amer. 

Med.  Assoc,  vol.  77,  No.  20,  1921,  1541. 
Chick,  Harriette,  and  Dalyell,  J.:    Eine  Skorbutepidemie  unter 

Kindern  im  Alter  von  6  bis  14  Jahren.  Ztschr.  f.  Kdh.,  26, 

1920,  257. 
Dittrich,  Johanna:  Speiseplane  fur  kleinere  Kinder,  in  Pirquet, 

System  d.  Ernahrung,  III,  p.  129. 
Edelstein,  F.,  and  Langstein,  L.:   Das  Pirquet'sche  System  der 

Ernahrung.  Berl.  Klin.  Wchnschr.,  1920,  823  and  852. 
Aussprache  iiber  den  Vortrag  liber  Das  Pirquet'sche  Sys- 
tem der  Ernahrung.  Berl.  Klin.  Wchnschr.,  1920,  715. 
Edelstein:  Referat  iiber  das  Lehrbuch  der  Volksernahrung  nach 
dem  Pirquet'schen  System.    Zentralbl.  fur  die  ges.  Kdh.  Bd. 
10,  1921,  33. 

68 


BIBLIOGRAPHY  69 

Edelstein:  Energiehaushalt  und  Ernahrung,  Ubersichts-Referat, 
Zentralbl.  fur  die  ges.  Kdh.,  Bd.  9,  1920,  129. 

Faber,  Harold  K.:  Von  Pirquet's  Feeding  System,  American 
Jour,  of  Dis.  of  Children,  19,  478. 

Germann,  A.  K. :  High  Sugar  Feeding,  Med.  Clin,  of  North  Amer- 
ica, Vol.  3,  No.  6,  1920,  1559. 

Gironcoli,  U.  de:  Jl  sistema  dietetico  de  Pirquet,  La  Pediatria: 
Vol.  30,  Fasc.  4,  1922. 

Gray,  H.,  and  Howard  F.  Root:  Weight  Prediction  by  the  For- 
mulae of  Bornhardt,  of  von  Pirquet,  and  of  Dreyer,  Boston 
Med.  and  Surg.  Jour.,  185,  28. 

Groer,  F.  V.:  Ernahrungsversuche  bei  infektionskranken  Kindern, 

I.  tiber  die  Durchfiihrung  quantitativer  Ernahrungstherapie 
der  akuten  Infektionskrankheiten,  Ztschr.  f.  Kdh.,  23,  1919. 
125. 

Ernahrungsversuche     bei     infektionskranken     Kindern. 

II,  Mastkuren  bei  Kinderruhr,  Ztschr.  f.  Kdh.,  23,  1919, 
221. 

Ernahrungsversuche  bei  infektionskranken    Kindern,  III, 

Uber  die  Bemessung  der  taglichen  Nahrungszufuhr  bei 
Infektionskrankheiten,  Ztschr.  f.  Kdh.,  23,  1919,  293. 

Rationelle  Ernahrung    der  Kinder  nach  dem  System  v. 


Pirquet  in  einfachen  Massenbetrieben,  Ztschr.  f.  Kdh.,  18, 

1918,  297. 
Hamburger,  F.,  and  Jellenigg:    Die  Gelidusimethode  zur  Fest- 

stellung  des  Ernahrungszustandes,  Wien.  klin.  Wchnschr., 

1920,  1131. 
Hecht,  A.  F. :   Bestimmung  des  Nemwertes  aus  dem  spezifischen 

Gewicht,  System  der  Ernahrung,  IV,  Teil,  Berlin,  Julius 

Springer,  1920. 
Heller,    Oskar:     Zur   Wirkungsweise    konzentrierter    Sauglings- 

nahrungen,  Monatschr.  f.  Kdh.  19,  1921,  391. 
Heller,  R.:    Uber  den  Wert  der  Indices  zur  Beurteilung  des 

Ernahrungszustandes   von    Kindern    bei   Massenuntersuch- 

ungen,  Wien.  med.  Wchnschr.,  1921,  1415. 


70    THE  PIRQUET  SYSTEM  OF  NUTRITION 

Helmreich,  Egon,  and  Schick,  Bela:  t)ber  konzentrierte  Ernahrung 
und  deren  Indikation  (besonders  im  Sauglingsalter). 

tJber  konzentrierte    Ernahrung,  II,  Mitteilung,  Einfluss 

wechselnder  Konzentration  auf  Korpergewicht  und  Ham- 
menge  des  Sauglings,  Ztschr.  f.  Kdh.,  30,  1921,  147. 

Ernahrungsstudien    beim  Neugeborenen,  IV,  Mitteilung, 

Ztschr.  f.  Kdh.,  30,  1921,  363. 

Hjarne,  Urban:   Einige  Beobachtungen  betreffend  Korperlange, 

Korpergewicht  und   Ernahrungszustand,   Acta   paediatrica, 

Vol.  I,  fasc.  3,  Uppsala. 
Hopkins,  F.  G.:   The  Huxley  Lecture  on  Recent  Advances  in 

Science  in  their  Relation  to  Practical  Medicine   and  the 

Nutritional    Requirements    of    the    Body,    The    Lancet, 

1921. 
Jde,  Toshio:    Tryptophanaufnahme  und  Tryptophanbedarf  im 

Kindesalter,  Ztschr.  f.  Kdh.,  31,  1922,  257. 
Jelenigg,  Karl:  Darmlange  und  Sitzhohe,  Wien.  klin.  Wchnschr., 

1921,  604. 
Kassowitz,  Karl:  Zur  Frage  der  Beeinflussung  der  Korperlange 

und  Korperfulle  durch  die  Ernahrung,  Ztschr.  f.  Kdh.,  30. 

1921,  275. 

Neue    Wege  der  Ernahrungsfiirsorge,  Kalender  der  oster- 

reichischen  Volkszeitung,  Jahrgang,  1922. 

Kleinsasser,  E.:  Studie  iiber  die  Ernahrungs-  und  Wachstums- 
verhaltnisse  der  Tiroler  Schuljugend,  Mitt.  d.  Gen.  Kommiss. 
d.  amerik.  Kinderhilfsaktion,  1921,  125. 

Langstein:    Pirquet's    System    der    Ernahrung,    Mediz.  Klinik, 

1918,  601. 

Lendl,  Marietta;  Anstaltskost,  in  Pirquet,  System  d.  Ernahrung, 

III,  p.  105. 
Loewy,    A.:     Referat   iiber   Pirquet's    System   der   Ernahrung, 

Deutsch.  med.  Wchnschr.,  1917,   1433  and  1919,  945  and 

1201. 
Mayerhofer,  Ernst:    Ernahrungskunde,  Wien.  klin.  Wchnschr., 

1919,  1039. 


BIBLIOGRAPHY  71 

Mayerhofer,  Ernst:  Beitrage  zur  Geschichte  der  quantitativen 
Ernahrungslehre,  Wien.  med.  Wchnschr.,  1902,  1539. 

Das  osterreichische    Hauptkommissariat  fiir  die  Lander 

mit  Ausnahme  von  Wien  und  Niederosterreich,  Wien.  klin. 
Wchnschr.,  1921,  324. 

Bemerkungen    zur  Mitteilung  von  R.  Heller  iiber  den 

Wert  der  Indices  zur  Beurteilung  des  Ernahrungszustandes 
von  Kindera  bei  Massenuntersuchungen,  Wien.  med. 
Wchnschr.,  1921,  1598. 

Therapie  der  Kinderkrankheiten  in  Landesmann,  Thera- 

pie  an  den  Wiener  Kliniken,  Wien  Deuticke,  1922. 

Medizinische    Studie     iiber    die    amerikanische    Kinder- 

hilfsaktion  in  Osterreich,  Mitteilungen  d.  Gen.  Kommiss. 
d.  amerik.  Kinderhilfsaktion,  Jg.,  1920,  S.  5. 

Los  medios    auxiliares  naturales  en  la  lucha  contra  la 

tuberkulosis  de  la  infancia,  Revista  medica  de  Hamburgo, 
1921,  Nos.  11  and  12. 

Kiiche  und  Volksernahrung,  Kalender  der  Volkszeitung, 

1921,  Seite  102-104.  (Wien.,  printed  and  published  by 
"Steyrermiihl.") 

Mayerhofer,  E.,  and  CI.  Pirquet:  The  American  Relief  Admin- 
istration European  Children's  Fund  in  Austria.  Printed  by 
J.  Weiner,  Vienna.     Edited  by  the  General-Commissariat. 

Mayerhofer,  E.,  and  Pirquet,  C:  Lehrbuch  der  Volksernahrung 
nach  dem  Pirquet'schen  System,  Wien-Berlin,  Urban  and 
Schwarzenberg,  1920. 

Mayerhofer,  E.,  and  Reischl,  Friedrich:  "Ernahrungskunde," 
Osterr.  Almanach  fiir  Ernahrung,  1921-1922.  M.  Salzer, 
Wien.,  1921. 

Merill,  Th.,  and  H.  Violle:  Les  grandes  formules  modernes  de  la 
nutrition,  leur  applications  pratiques,  Presse  med.,  Jg.  29, 
No.  94,  S.  931,  1921. 

Meyer,  F.  L.:  Referat  iiber  C.  Pirquet,  System  der  Ernahrung, 
Deutsche  med.  Wchnschr.,  1921,  575. 


72    THE  PIRQUET  SYSTEM  OF  NUTRITION 

Miari,  Rosa:  Allgemeine  Kiiche,  Pirquet,  System  d.  Ernahrung, 
III,  p.  32. 

Speiseplane  fur  altere  Kinder  und  Erwachsene,  Pirquet, 

System  d.  Ernahrung,  III,  p.  137. 

Niemann:  Referat  liber  E.  Mayerhofer  und  C.  Pirquet,  Lehrbuch 

der    Volksernahrung     nach    dem     Pirquet'schen     System, 

Deutsche,  med.  Wchnschr.,  1920,  1377. 
Nobel,   E.:    Grundziige    des   Pirquet'schen   Ernahrungssystems, 

Wien  und  Leipzig,  Josef  Safar,  Ubersetzungen :    Kroatisch, 

Polnisch,  Englisch,  Russisch,  Tschechisch. 
Praktische  Durchfuhrung  des  Ernahrungsystems  in  einem 

Militarspitale,  Pirquet,  System  d.     Ernahrung,  II,  p.  390. 

tiber  den  Wasserhaushalt  des  kindlichen  Organismus,  die 

Grenzen  der  Wasserentziehung  und  ihre  systematische 
Anwendung  bei  pathologischen  Zustanden,  Ztschr.  f.  Kdh., 
22,  1919,  i. 

Zur  Aufklarung  iiber  das  Nemsystem,  Wien.  klin.  Wchn- 
schr., 1920,  965. 

Einiges    iiber   die    amerikanische    Kinderausspeisung   in 

Wien  und  Niederosterreich,  Wien.    klin.  Wchnschr.,   1921, 

325. 

Organisatorische    Aufgaben   bei   Massenspeisungen   von 

Kindern.     In  Mayerhofer-Pirquet. 

Grundziige  des  Nemsystems.     In  Mayerhofer-Pirquet. 

Sauglingsernahrung,  Wien.  med.  Wchnschr.,  17/18,  1922. 

Schulerspeisung  in  Wien.  Wien,  Safar,  1921. 

Schulerspeisung    in    den    Stadten   und    kleineren    Orten 

Niederosterreichs,  Wien,  Safar,  1921. 

Zur   Barlowfrage    Bedeutung   der   Hitzewirkung  auf  die 

Vitamine,   Beitrag  zur  Frage  der  Nahrungskonzentration, 
Ztschr.  fur  Kdh.,  28,  Heft  5/6,  1921. 

Beitrag  zur  Barlowfrage,  Wien.  klin.  Wchnschr.,  1920/52. 

Nobel,  E. :  Praktische  Durchfuhrung  des  Ernahrungssystems  von 

Pirquet  in  einem  Militarspitale,  Wien.  med.  Wchnschr.,  1917, 
No.  51. 


BIBLIOGRAPHY  73 

Noble,  E.,  and  Toshio  Jde.:  Beitrag  zur  konzentrierten  Ernah- 
rung  des  Sauglings.    Ztschr.  fur.  Kdh.,  1922. 

Nobel,  E.,  and  Wagner,  R. :  Trockenmilch  in  der  Kinderernahrung, 
Ztschr.  f.  Kdh.,  30,  1921,  291. 

Richtlinien  zur   Massenspeisung  der  Kinder,  Wien.  med. 

Wchnschr.,  1920,  1594. 

Panzer,  Paula:  Die  graphische  Darstellung  des  Appetites  und  der 
Bewegung  der  Sauglinge  auf  den  Ubersichtskurven,  Ztschr. 
f.  Kdh.,  29,  1921,  90. 

Ernahrungsschule  fiir    Sauglinge  in  Pirquet,   System  d. 

Ernahrung,  III,  p.  120. 

Pfaundler,  M.:  Uber  die  Indices  der  Korperfulle  und  iiber  "Un- 

terernahrung,"  Ztschr.  f.  Kdh.,  29,  1921,  217. 
Pirquet,  Clemens  Freiherr  von:    System  der  Ernahrung,  Erster 

Teil,  Berlin,  Julius  Springer,  1917. 
■ System    der  Ernahrung,  Zweiter  Teil,  Mit  Beitragen  von 

Prof.  Dr.  B.  Schick,  Dr.  E.  Nobel  und  Dr.  F.  v.  Groer,  Berlin, 

Julius  Springer,  1919. 
System    der  Ernahrung,   Dritter  Teil:    Nemkuche.   Mit 

Beitragen    von    Schwester    Johanna    Dittrich,    Schwester 

Marietta  Lendl,   Frau   Rosa  Miari  und   Schwester  Paula 

Panzer,  Berlin,  Julius  Springer,  1919. 

System    der  Ernahrung,  Vierter  Teil,  Mit  Beitragen  von 

Prof.  F.  v.  Groer,  Doz.  Dr.  A.  Hecht,  Doz.  Dr.  E.  Nobel, 
Prof.  Dr.  B.  Schick,  Dr.  R.  Wagner  und  Dr.  Th.  Zillich, 
Berlin,  Julius  Springer,  1920. 

Sitzhohe  und  Korpergewicht,  Ztschr.  f.   Kdh.,  14,  1916, 

211. 

Die  Milch  als  Nahrungseinheit,  Ztschr.  f.  Kdh.,  14,  1916, 

197. 

Die  einzelnen    Nahrungsstoffe,  Ztschr.  f.  Kdh.,  14,  1916, 

,   449. 

Ernahrung  nach    der  Darmflache,  Ztschr.  f.  Kdh.,  15, 

1917,  100. 


74    THE  PIRQUET  SYSTEM  OF  NUTRITION 

Pirquet,  Clemens  Freiherr  von:  Tafel  zur  Ernahrung  des  Men- 
schen,  Ztschr.  f.  Kdh.,  15,  1917,  117. 

Tafeln    fur    den  Einkauf  von   Nahrungsbrennstoff   und 

Nahrungseiweiss,  Ztschr.  f.  Kdh.,  15,  1917,  136. 

Korpergewicht  und  Darmflache,  Ztschr.  f.  Kdh.,  15,  1917, 

213. 

Der  Nahrwert  des*Fleisches,  Ztschr.  f.  Kdh.,  16, 1917,  241. 

tlber  den  Nahrungswert  der  Milch  und  seine  Bestimmung 

aus  der  Trockensubstanz,  Ztschr.  f.  Kdh.,  17,  1918,  114. 

tiber  den  Nahrungswert  der  Kartoffel  und  seine  Bestim- 
mung aus  der  Trockensubstanz,  Ztschr.  f.  Kdh.,  17, 1918, 145. 

Berechnung   des  Nemwertes  von  Gemiise,  Obst  und  Ge- 

tranken  aus  der  Trockensubstanz,  Ztschr.  f.  Kdh.,  18,  1918, 
167. 

tJber  den   Nemwert  von  Pflanzensamen,  Mehl,  Brot  und 

Teigwaren,  Ztschr.  f.  Kdh.,  18,  1918,  185. 

Bestimmung  des  Nemwertes  der  Butter  aus  der  Trocken- 
substanz, Ztschr.  f.  Kdh.,  18,  1918,  201. 

Der     Nemwert    von    Rahm,    Magermilch,    Butterrnilch, 

Molken,  Kase,  Wiirsten,   Fleisch-   und    Fisch-Dauerwaren, 
Ztschr.  f.  Kdh.,  18,  1918,  207. 

Bestimmung  des    Ernahrungszustandes,  Ztschr.  f.  Kdh., 

18,  1918,  220. 

Die  Aufgaben  der   Kiiche,  Ztschr.  f.  Kdh.,  18,  1918,  249. 

Der  Nemwert  von  Fettgewebe  und  von  ganzen  Schlacht- 

tieren,  Ztschr.  f.  Kdh.,  18,  1918,  270. 

tiber  Nahrungsbedarf  und   Gewichtszunahme   der  Sau- 

glinge,  Ztschr.  f.  Kdh.,  18,  1918,  274. 

Der  Begrifl  "Aequum,"  Ztschr.  f.  Kdh.,  30,  1921,  145. 

System  der  Ernahrung,  Munchen.  med.  Wchnschr.,  1917, 

515. 

Die   amerikanische  Schulausspeisung  in  Osterreich,  Wien. 

klin.  Wchnschr.,  1921,  323. 

Die  amerikanische  Kinderhilfsaktion  in  Osterreich,  Wien. 

med.  Wchnschr.,  1920,  854  and  907. 


BIBLIOGRAPHY  75 

Pirquet,  Clemens  Freiherr  von:  Quantitative  Ernahrungstherapie, 
Ther.  Mh.,  1917,  Okt. 

Die     amerikanische     Kinderhilfsaktion     in     Osterreich, 

Osterr.  Rundschau,  Bd.  bdii,  Heft  6  (1920). 

Nutritional   Treatment  of  Tuberculosis,  New  York  Med. 

Journal,  Feb.  1,  1922. 

Pirquet,  Clemens  and  Mayerhofer,  Ernst:  The  American  Relief 
Administration  European  Children's  Fund  in  Austria.  Print- 
ed by  J.  Weiner,  Vienna.  Edited  by  the  General-Commissa- 
riat. 

Lehrbuch  der  Volksernahrung.      Wien  Berlin  Urban  u. 

Schwarzenberg,  1920. 

and  E.  Wolf  el:  Milchsalze,  Ztschr.  f.  Kdh.,  17,  1918,  141. 

Progulski,  Stanislaw:  O  rokowaniu  i  leczeniu  tezca  noworodk6w, 

Polska  Gazeta  Lekarska,  No.  17, 1922. 
Rach,  E.:    Die  Milch  als  Vergleichseinheit  fiir  die  Nahrwert- 

konzentration  der  Nahrungsmittel,  Miinchen.  med,  Wchn- 

schr.,  1919,  1196. 
Reischl,  Friedrich:    "Das  Pirquet'sche  Ernahrungssystem,"  in 

"Wiens  Kinder  und  Amerika,"  Seite  120-140,  Gerlach  and 

Wiedling,  1919. 
"Die   Ernahrung  nach  dem  Nem-System,"  Populare  und 

sehr    kurze    Darstellung,    Krakauer    Kalender,    1921.    M. 

Salzer,  1920. 

"Mitteilungen  der  Amerik.    Kinderhilfsaktion  (American 

Relief  Administration"),   Bd.   I,   II,  III,   Generalkommis- 
sariat  der  A.  K.  H.  A.    Printed  by  M.  Salzer. 

Reischl,  Freidrich,  und  Mayerhofer,  Ernst :   "Ernahrungskunde," 

Ost.  Almanach  f.  Ernahrung,  1921-1922.    M.  Salzer,  1921. 
Rosenfeld,  S. :  Zur  Aufklarung  iiber  das  Nemsystem.  (Zu  Nobels 

Aufsatz  in  der  Wien.  Klin.  Wchnschr.,  1920,  No.  44),  Wien. 

klin.  Wchnschr.,  1920,  1051. 
Schick,  Bela:  Ernahrungsstudien  beim  Neugeborenen,  Ztschr.  f. 

Kdh.,  17,  1918,  1.  s.  Pirquet,  System  der  Ernahrung,  II, 

p.  148. 


76    THE  PIRQUET  SYSTEM  OF  NUTRITION 

Schick,  Bela:  Ernahrungsstudien  beim  Neugeborenen,  II,  Mit- 
teilung,  Ztschr.  f.  Kdh.,  22,  1919,  195. 

Ernahrungsstudien  beim    Neugeborenen,  III,  Mitteilung, 

Ztschr.  f.  Kdh.,  27,  1921,  57. 

und  Helmreich  Egon:  Ernahrungsstudien  beim  Neuge- 
borenen, IV,  Mitteilung,  Ztschr.  f.  Kdh.,  30,  1921,  363. 

Der  Nahrwertbedarf  der  stillenden  Frau,  Ztschr.  f.  Kdh., 

21,  1919,  284. 

Der  Nahrwertbedarf    der  Frau    im  letzten    Drittel  der 

Schwangerschaft,  Ztschr.  f.  Kdh.,  23,  1919,  26. 

Das  Pirquet'sche  System  der  Ernahrung  und  seine  Gegner, 

Ztschr.  f.  Kdh.,  28,  1921,  62. 

■    Das    Pirquet'sche  System  der  Ernahrung;  fur  Arzte  und 

gebildete  Laien,  Berlin,  Julius  Springer. 

Darmlange    und  Sitzhohe,  Bemerkungen  zur  Publikation 

von  Dr.  Karl  Jellenigg  in  der  Wien.  klin.  Wchnschr.,  No.  50, 
1921;  Wien.  klin.  Wchnschr.,  1922,  58. 

Stoeltzner,    W.:     Energiequotient,    Nemsystem,    Bedarfsrlache, 

Miinchen.  med.  Wchnschr.,  1921,  1518. 
Terner,  Karl :  Das  Wachstum  und  die  Lange  des  Darmkanals  im 

Kindesalter,  Verhaltnis  der  Darmlange  zur  Sitzhohe,  Ztschr. 

f.  Kdh.,  21,  1919,  408. 
Wagner,  Richard:    Die  zahlenmassige  Beurteilung  des  Ernah- 

rungszustandes  durch  Indices,  Ztschr.  f.  Kdh.,  28,  1921,  38. 

Korrekturtabelle  fur  Kuhmilch,  in  Pirquet,  System  der 

Ernahrung,  IV,  Teil,  p.  10. 

Trockensubstanzbestimmungen    in    fertigen    Speisen,    in 

Pirquet,  System  d.  Ernahrung,  p.  12. 

Fettbestimmungen  in  fertigen  Speisen,  in  Pirquet,  System 

der  Ernahrung,  IV,  Teil,  p.  22. 

Praktische   Handhabung  der  Kontrolle  des  Backprozesses 

mittels  der  Trockensubstanzbestimmung  des  Brotes,  in 
Pirquet  System  der  Ernahrung,  IV,  Teil,  p.  28. 

Walgren,  Arvid:  On  Pirquet's  Nutritionslara,  Upsala  Lukare- 
forenings  forhandlingar,  Bd.  xxvii,  H.  1-2,  1922,  53. 


BIBLIOGRAPHY  77 

Wimberger,  Hans:  Beziehung  zwischen  Nahrungskonzentration 
und  Blutbeschaffenheit,  Ztschr.  f.  Kdh.,  25,  1920,  64. 

Eineiige   Zwillinge,  Ztschr.  f.  Kdh.,  31,  1921,  216. 

Zillich,  Therese:  Nahrungsmenge  und  Ernahrungszustand  in 
Pirquet  System  der  Ernahrung,  IV,  Teil,  Berlin.  Julius 
Springer,  1920. 


NEM  VALUE  OF  THE  PRINCIPAL  FOOD-STUFFS 

The  table  contains  the  following  references: 

1.  Nem  in  1  gram.  The  number  of  nems  contained  as  an  average  in  1  gram 
of  the  article  in  question. 

m  2.  Hektonem  weight.    The  number  of  grams  of  each  article  of  food  con- 
tained in  1  hektonem  (100  nems)  food  value. 

3.  Protein  value.  Approximate  amount  of  dekanems  protein  in  one  hektonem 
of  the  article. 

4.  Formula.  For  the  purpose  of  a  more  exact  determination  of  food  values 
it  is  necessary  to  make  a  simple  chemical  examination  of  the  article,  deter- 
mining the  dry  substance  (T),  the  content  in  fats  (F),  and  ashes  (A).  The 
details  of  this  examination  are  found  in  System  der  Ernahrung,  vol.  iv. 


Albumin,  dry 

fresh  (egg  white) . 
Almonds,  sweet. . .  . 
Anchovy  in  oil 

salted 

Aniseed 

Apple 

dried 

Apricots 

Artichokes 

Asparagus 

Baby  food 

with  milk 

without  fat. 

Bacon 

Banana 

Barley 

flour 

Batata 

Beans,  dried 

flour 

fresh 

Beech-nuts 

Beef  (fat  beef  meat) 

lean 

medium 

smoked 

soup  (broth) 

Beef  fat  (dripping) . 
Beer,  malted 

strong 

weak 

Beets,  red 

sugar 

white 


Nem 

in  1 

gram. 

Hekto- 
nem 
weight, 
grams. 

Protein 
value. 

Formulas. 

5 

20 

9 

0.67 

150 

9 

6T 

8 

12.5 

1 

4.2T+8.3F 

3 

33 

5 

6(T-A)+7.5F 

1.5 

67 

6 

3.3 

30 

2 

0.67 

150 

0.5 

5T 

3.3 

30 

0.5 

5T 

0.67 

150 

0.5 

3.5T 
4T 

0.25 

400 

2 

3.5T 

5.5 

18 

1 

5.5T+8F 

5 

20 

1 

5.5T 

10 

10 

0.5 

6(T-A+7.5F) 

1 

100 

0.5 

4.5 

22 

1 

5.2T 

5 

20 

1 

5.5T 

1.25 

80 

0.5 

5T 

4 

25 

2 

4.5T 

5 

20 

2 

5.5T 

0.5 

200 

2 

4.5T 

6.7 

15 

1 

4.2T+8.3F 

4 

25 

3 

15.4T-2.22 

1.5 

67 

8 

2.5 

40 

4 

5.7F+7.8F 

5 

20 

3 

0.1 

1000 

3 

6(T-A)+7.5F 

13.3 

7.5 

0 

13. 5T 

0.67 

150 

0 

5.8T 

0.33 

300 

0 

5.8T 

0.2 

500 

0 

5.8T 

0.4 

250 

1 

4.5T 

1 

100 

0.5 

0.4 

250 

1 

4.5T 

80    THE  PIRQUET  SYSTEM  OF  NUTRITION 


Biscuits,  rich . 
without  fat 
Blackberries. . 
Blood 


(coarse) . 


sausage 

Blueberries 

Boletus  (mushroom) 

Bologna  sausage 

Bone-marrow 

Bones 

Bouillon 

cubes 

Brains 

Bread,  brown  (mixed) 

coarse 

crumbs,  dried 

white 

Brie  cheese 

Brown  hominy  (pumpernickel) 

Brussel  sprouts 

Buckwheat  (flour) 

Butter 

fresh  (not  salted) 

medium  salted 

Buttermilk 


Nem 

in  1 

gram. 


Cabbage,  red,  dry 

fresh 

white. 

Calf,  brains , 

entire  living  animal , 

feet 

lungs , 

pluck  (thymus) 

Candy  without  butter 

Cane-sugar 

Canned  meat 

Capon,  fat 

Caraway  seeds 

Carp,  fresh,  fat 

lean 

Carrots 

Cartilage 

Cauliflower 

dry. 

Caviar 

Celery 

Cheese,  dry  (skimmed  milk). 

fat,  soft  (cream) 

medium  (whole  milk) 

soft  (skimmed  milk) 


6.7 
5 

0.5 
1.25 
4 

0.5 
0.4 
8 
12 
3.3 
0.1 

i'.'s 

3.3 
3 
5 
4 
5 
3 

0.4 
5 
12 


0.5 

3.3 

0.33 

0.4 

1.5 

2.5 

2.5 

1.25 

1.5 

6 

6 


Hekto- 

nem 
weight, 
grams. 


15 

20 
200 

80 

25 
200 
250 

12.5 
8.5 

30 
1000 

"67 

30 
33 
20 
25 
20 
33 
250 
20 
8. 


200 

30 

300 
250 
67 
40 
40 
80 
67 
17 
17 


Protein 
value. 


Formulas. 


2.5 

40 

4 

3.3 

30 

2 

2.0 

50 

5 

1.5 

67 

7 

0.5 

200 

1 

2.5 

40 

5 

0.4 

250 

2 

3.3 

30 

2 

4 

25 

4 

0.67 

150 

1 

4 

25 

5 

6 

17 

3 

5 

20 

4 

2.5 

40 

6 

1 
1 

0. 

9 

1 

0. 

3 

2 

0 

2 

3 

i 
i 
i 

i 

2 
1 
2 
1 
0 


2 
2 
2 
3 

S 

7 
9 

0 
0 


5.5T+8F 

5.5T 

3.5T 

5.9T 

6(T-A)+7.5F 

2.5T 

4.5T 

6(T-A)+7.5F 

6(T-A)+7.5F 

6(T-A)+7.5F 

6(T-A)+7.5F 

5.5T+8F 

5.5T 

5.2T 

5.5T 

5  8T 

6(T-A)+7.5F 

5T 

4T 

5.5T 

13.4(T-A) 

13.5T-0.1 

13.5T-0.3 

13.5F-J-0.5 

13.5T-0.72 

4T 

4T 

5.5T+8F 

6(T-A)+7.5F 


5.9T 
5.9T 

6(T-A)-|-7.5F 
15.4T-2.22 

13.5T-1.57 
13.5T-1.57 
4.5T 

6(T-A)+7.5F 
4T 

6(T-A)+7.5F 

4.5T 

6(T-A)+7.5F 

6T+7.5F-0.3 

6(T-A)+7.5F 


NEM  VALUE  OF  PRINCIPAL  FOOD-STUFFS  81 


Cherries,  sour  and  sweet 

Chestercheese 

Chestnuts 

Chicken,  fat 

lean 

Chitterlings 

Chives 

Chocolate 

Cinnamon 

Cocoa  powder 

Cocoanut 

oil 

Cod-liver  oil 

Codfish,  dried 

fresh 

salted 

Codling 

Condensed  milk,  sweetened. 

unsweetened 

Corn,  dry,  whole 

Cornmeal 

flour,  fine 

medium 

Cornstarch 

Cow's  meat,  lean 

medium 

milk 

Cranberries 

Cream 

Cream-cheese 

Cucumbers 

Curds  (milk) 

Currants 

Dates,  dried 

Dextrose 

Dill 

Donkey's  milk 

Dove-meat  (pigeon) 

Dried  fruit 

vegetables 

Dripping 

Duck 

Dutch-cheese 

Edam  cheese 

Eel  in  jelly 

river 

sea 

Egg,  white,  dried 

fresh 

whole , 


Nem 

in  1 

gram. 


0.67 

6 

2.5 

2.5 

1.5 

6"5* 

6.7 

3.3 

6 

9 

13.3 
13.3 

5 

1 

i" 

5 

3.3 

4 

5 

5" 

5 

1.5 

2.5 

1 

0.5 

3.3 

6 

0.2 

2.5 

0.67 

4 
5 

0.4 
0.67 
1.5 
3.3 
3.3 
13.3 
2 
6 

6 
3 
4 
2 
5 
0.67 


Hekto- 
nem 

weight, 
grams. 


150 
17 
40 
40 
67 

'266 

15 

30 

17 

11 

7.5 

7.5 

20 

100 

166 
20 
30 
25 
20 

'26 

20 

67 

40 
100 
200 

30 

17 
500 

40 
150 

25     i 

20     i 
950 
?50     j 
X67 

30 

30 
7.5 
50 
17 

17 
33 
25 
50 
20 
150 
40 


Protein 
value. 


0.5 

3 

1 

4 

8 

"l" 
0.5 
1 
1 

0.5 
0 
0 
9 
9 

9" 

1 

2 

1 
1 

i" 

0 

8 

4 

2 

0.5 

1 

3 

2 

6 

0.5 

0.5 
0 

1 

8 

0.5 

0.5-3 

0 

6 

3 

3 

2 

2. 

5 

9 

9 

3 


Formulas. 


4T 
6T4-7.5F-0.3 

15.4T-2.22 

5 .  5T+8F 

4T 

5.3T+7.2F 

4.2T+8.3F 

4.2T+8.3F 

13. 5T 

13. 5T 

5.7T 

5.7T 

6.KT-A) 

5.7T 

6(T-A)+7.5F 

6(T-A)+7.5F 

5.5T 

5.8T 

5.5T 

6T 

6(T-A)+7.5F 

15.4T-2.22 

13.5F+0.5 

3.5T 

13.5F+0.5 

6(T-A)+7.5F 

4T 

6T+7.5F-0.3 
4T 

5.9T 

11T-0.4 

6T 

4T 

4T 

13. 5T 

15.4T-2.22 

6T+7.5F-0.3 

6T+7.5F-0.3 
6(T-A)+7.5F 
13.5T-1.57 
13. 5T  -  1.57 

6T 

5.5T+8F 


82    THE  PIRQUET  SYSTEM  OF  NUTRITION 


Egg,  yolk,  fresh. 

dried 

Endive,  raw. . .  . 


Farina. 
Fat. . . 


Nem 

in  1 

gram. 


Fatty  tissue 

Fennel 

Figs,  dried 

green 

Fish  flesh,  fat 

lean 

medium 

salted 

roe 

Flounder,  fresh 

Flour,  coarse 

fine . 

macaroni,  etc 

medium 

plain  biscuit  (dry) 

rich 

preparations  (puddings): 

rich 

without  butter 

Food  preparations  with  egg. . . . 

Frankfort  sausage 

French  beans 

Fruit,  acid 

(blackberries,  blueberries, 
raspberries,  cranberries) 

dried 

jelly 

juice 

medium 

(plums,  greengages,  ap- 
ples, pears,  prunes,  or- 
anges, peaches,  straw- 
berries, gooseberries,  cur- 
rants, apricots) 

stewed 

sweet 

(raisins,  pomegranates,  figs) 

Game 

Garlic,  dried 

fresh 

Gelatin 

German  sausage 

Gervais  cheese 

Gingerbread 


5 
9 


5 

13.3 
12 

3.3 

3.3 

1 

2 

1 

1.25 

i" 
1 

5*" 

5 

5*" 
6.7 


7 
5 
0.5 


3.3 
0.4 
0.67 
0.67 


1.5 
3.3 
0.5 

6*.  1 
6 

5 


Hekto- 

nem 

weight, 

grams. 


20 
11 


20 

7. 

7. 

30 

30 

100 

50 

100 

80 

'25 
100 

'26 
20 

'26 
15 

25 

33 

20 

15 

200 

200 


30 
250 
150 
150 


Protein 
value. 


100 


67 

30 

200 

15 
17 
20 


1 

0 

0 

2 

0.5 

0.5 

5 

9 

9 

4" 
9 
.„. 

1 

i" 

1 

1 
1 
9 
1 

2 
0.5 


0.5 
0 
0 
0.5 


0.5 


8 
1 
1 

"l 

2 
0. 


Formulas. 

5.5T+8F 

4T 

5.5T 
13. 5T 
13. 4T 


4.5T 

13.5T-1.57 
5.7T 

6.1(T-A) 

6(T-A)+7.5F 

5.7T 

5.2T 

5.8T 

5.8T 

5.5T 

5.5T 

5.5T+8F 

5.8T+7.7F 

5.5T 

6T 

6(T-A)+7.6F 

4.5T 


4T 

5.7T 

5.7T 


4T 
4T 


15.4T-2.22 

4.5T 

6(T-A)+7.5F 
6(T-A)+7.5F 
6(T-A)+7.5F 
5.8T 


NEM  VALUE  OF  PRINCIPAL  FOOD-STUFFS  83 


Glucose 

Goat's  meat 

milk 

Gooseberries 

Goose  breast,  smoked 

liver 

meat,  fat 

Gorgonzola  cheese 

Graham  bread  (whole  meal) . 

Grape-sugar 

Grapes 

Gravy 

Greaves 

Gruel  (see  Milk  preparations) 
Gudgeon 

Haddock,  dry 

fresh 

salted 

Ham,  smoked 

Hare 

Hazelnuts 

Heart 

Herring,  fresh 

pickled 

smoked 

Honey 

Horse  meat 

milk 

Horse-radish 

Human  milk 

Ice-cream 

Jam 

Jelly  of  fruit 

Juniper  berries 

Kajmak  cheese 

Kefir 

Kidney 

Kohlrabi 

Koumiss 

Kufeke  (baby  food) 

Lager-beer 

Lamb,  entire  living  animal. . . 

Lard 

Leek 


Nem 

in  1 

gram. 

Hekto- 
nem 

Protein 

weight, 
grams. 

value. 

5 

20 

0 

2 

50 

6 

1 

100 

2 

0.67 

150 

0.5 

5 

20 

3 

5" 

"20 

2" 

6 

17 

3 

3 

33 

1 

5 

20 

0 

1 

100 

0.5 

1 

100 

3 

6.7 

15 

4 

1.25 

80 

8 

5 

20 

9 

1 

100 

9 

5" 

"26 

'3" 

1.5 

67 

8 

9 

11 

1 

2.5 

40 

4 

2 

50 

5 

3.3 

30 

5 

2.5 

40 

5 

5 

20 

0 

1.5 

67 

8 

0.67 

150 

1 

1 

100 

1 

1 

100 

1 

3.3 

30 

•  •  •   • 

0 

0.4 

250 

0 

3.3 

30 

1 

6 

17 

2 

0.67 

150 

2 

1.5 

67 

6 

0.4 

250 

1 

0.67 

150 

2 

5 

20 

1 

0.33 

300 

0 

4 

25 

13.3 

7.5 

0 

0.4 

250 

2 

Formulas. 


5.9T 

15.4T-2.22 

13.5F+0.5 

4T 

6(T-A)+7.5F 

5.5T+8F 

15.4T-2.22 

6T+7.5F-0.3 

5.2T 

5T 

6(T-A)-f7.5F 
6(T-A)+7.5F 

5.7T 

5.7T 

5.7T 

6.1  (T-A) 

6(T-A)+7.5F 

6T 

4.2T+8.3F 

5.7T+7.8F 

13.5T-1.57 

6(T-A)+7.5F 

6(T-A)+7.5F 

5.9T 

6T 

11T-0.4 

13.5F+0.5 

13.5T-0.67 

5.8T+7.7F 

6(T-A)+7.5F 


5T 

5.7T 


6(T-A)-f7  5F 

13.5F+0.5 

13.5T-1.57 

4T 

13.5F+0.5 

5.5T 

5.8T 

13. 5T 
4T 


84    THE  PIRQUET  SYSTEM  OF  NUTRITION 


Legumes,  dry  (Pulses) . 

flour 

Lemon 

Lentils 

Lettuce 

Levulose 

Linseed  oil 

Liqueur 

Liquorice 

Liver 


Nem 

in  1 

gram. 


sausage 

Lobster,  canned. 

fresh 

Lungs 


Macaroni 

Mackerel,  fresh 

Malt 

extract 

Malted  beer 

Marchpane 

Margarine 

Marjoram 

Marmalade 

Meat  cooked  or  roasted,  20% 

loss  of  water 

lean 

medium 

very  lean 

dried,  lean 

extract,  fluid 

semifluid 

solid 

fresh,  fat 

lean 

medium 

very  lean. 

smoked,  medium 

Medlar 

Melon 

Milk:  cow's  and  goat's 

dried,  whole 

general  formulas 


horse  and  donkey 

human 

preparations: 
porridge  and  gruel. 

sheep 

skimmed 

sugar 


4 

5 

0.67 
4 

0.2 
5 

13.3 
2 

3.3 
1.5 
6.7 
1.5 
1 
1.25 

5 

2.5 
5 
4 

0.67 
6.7 
12 
3.3 
3.3 


.5 
.3 


2. 

3. 

2 

5 

1 

3.3 

5 

5 

2 

2.5 

1.5 

4 


0.4 

1 

5 


0.67 
1 

1 

1.25 
0.5 
6 


Hekto- 

nem 
weight, 
grams. 


Protein 
value. 


Formulas. 


25 

20 
150 

25 
500 

20 
7. 

50 

30 

67 

15 

67 
100 

80 

20 

40 
20 
25 
150 
15 
8.5 
30 
30 


40 
30 
50 
20 
100 
30 
20 
20 
50 
40 
67 
25 

250 

100 

20 


150 
100 

100 
80 

200 
17 


2 

2 

0.5 

2 

2 

0 

0 

0 

2 

7 

1 

9 

9 

9 

1 

4 

0.5 

0 

0 

0.5 

0 

2 

0 


6 
4 

8 
7 
8 
8 
8 
2 
6 
4 
8 
4 


1 
1 

1 
2 
4 
0 


4.5T 

5.5T 

3.5T 

4.5T 

4T 

5.9T 

13. 5T 

5T 

13.5T-1.57 

6(T-A)+7.5F 
6(T-A)+7.5F 
6T 
5.5T+8F 

5.8T 

13.5T-1.57 

5.8T 

5.8T 

5.8T 

5.3T+7.2F 

13.4(T-A) 

5T 

5.7T+7.8F 

5.7T+7.8F 
5.7T+7.8F 
6(T-A)+7.5F 


6(T-A)+7.5F 

15.4T-2.22 

15.4T-2.22 

15.4T-2.22 

6T 

5.7T+7.8F 

4T 

4.5T 

13.5F+0.5 

5.5T+8F 

UT-0.4 

5.5T+8F 


5.5T+8F 


NEM  VALUE  OF  PRINCIPAL  FOOD-STUFFS  85 


Millet 

Mushrooms,  dried 

fresh 

Mussels  (clam) 

Mustard  seed 

Mutton,  fat 

lean 

medium 

Nestle's  baby  food 

Neufchatel  cheese 

Nutmeg 

Nuts 

Oatmeal 

Oats,  rolled 

Oil 

Olives,  fresh 

Onions,  dry 

fresh 

Oranges 

Ox,  entire  living  animal,  fat 

lean 

medium 

Oyster  meat 

whole 

Palm-oil 

Palmin,  vegetable  butter. .  . 

Parmesan  cheese 

Parsley 

Parsnip 

Partridge 

Pastry,  cake 

candy 

rich 

Peaches 

Pears,  dried 

fresh 

Peas,  dried 

green 

Pease  pudding 

Peppers,  red,  dried 

Perch 

Pig,  whole  animal,  fat 

lean 

Pigskin  (crackling) 

Pike,  fresh 

Pineapple 

Plaice 

Plums,  dried 

fresh 


Nem 

in  1 

gram. 

Hekto- 
nem 

Protein 

weight, 
grams. 

value. 

4.5 

22 

1 

3.3 

30 

3 

0.4 

250 

3 

1 

100 

6 

5 

20 

2 

5 

20 

2 

2 

50 

6 

2.5 

40 

4 

5.5 

18 

1 

6 

17 

2 

3.3 

30 

9 

11 

1 

5 

20 

1 

4.5 

22 

1 

13.3 

7.5 

0 

6 

17 

1 

3.3 

30 

1 

0.5 

200 

1 

0.67 

150 

0.5 

4 

25 

2.5 

40 

2 

3 

33 

3 

1 

100 

5 

0.1 

1000 

5 

13.3 

7.5 

0 

12 

8.5 

0 

5 

20 

4 

0.4 

250 

2 

1.5* 

"67 

s" 

5 

20 

0.5 

6 

17 

0 

6.7 

15 

0 

0.67 

150 

0.5 

3.3 

30 

0.5 

0.67 

150 

0.5 

4 

25 

2 

1 

100 

2 

6.7 

15 

1 

3.3 

30 

2 

1.25 

80 

8 

5 

20 

1 

3 

33 

2 

12 

8.5 

0 

6.67 

150 

0.5 

1.25 

80 

8 

3.3 

30 

0.5 

0.67 

150 

0.5 

Formulas. 


5.2 
4T 

15.4T-2.22 

5.7T+7.8F 

6T 

6(T-A)+7.5F 

4.2T+8.3F 

5.5T 
5.5T 
13. 5T 


4.5T 
4.5T 


6T 

13. 5T 
13. 4T 
6T+7.5F-0.3 

4.5T 

6T 

5.8T 

5.9T 

5.8T+7.7F 
3.5T 
4.5T 
4.5T 
4.5T 
4.5T 


13.5T~1.57 


13. 3T 

13.5T-1.57 

5T 

5.7T 

3.5T 


86    THE  PIRQUET  SYSTEM  OF  NUTRITION 


Nem 

in  1 

gram. 

Hekto- 

nem 
weight, 
grams. 

Protein 
value. 

Formulas. 

Plums,  jam 

3.3 

6.7 

5 

2 

6.7 

6 

4.5 

1.25 

4.5 

0.25 

3.3 

0.4 

2.5 

0.25 

0.5 

4 

0.5 

0.67 

0.4 

0.33 

2.5 

3.3 

0.2 

5 

4 

4 

5 

6 

3 

3.3 

5 

4 

3.3 
3.3 

1.25 

3 

0.33 

4 

6.7 

6.7 

2 

1 

0.5 

1.25 

30 
15 
20 
50 
15 
17 
22 
80 
22 
400 
30 

250 

40 

400 

200 

25 

200 

150 

250 

300 

40 

30 

500 

20 

25 

25 

20 

17 

33 

30 

20 

25 

30 
30 

"80 

33 

300 

25 

15 

15 

50 

100 

200 

80 

0 

1 

2 

6 

2 

1 

0.5 

0.5 

0.5 

2 

0.5 

1 

4 

2 

1 

0.5 

0.5 

0 

1 

2 

6 

2 

1 

0.5 

4 

1 

3 

3 

1 

1 

1 

1 

1 

4 

9*' 

5 

2 

1 

1 

2 

5 

9 

1 

2 

5T 

Poppy  -seeds 

4.2T+8.3F 

Pork, fat 

15.4T-2.22 

sausage 

6(T-A)+7.5F 

very  fat 

5.7T-1-7.8F 

Potatoes,  dry 

5T 

fresh 

5T 

mashed 

5T 

Potherbs 

Prunes,  dried,  without  stones  . . 
Puddings 

(see  Flour  preparations) . 

4T 

Quince-cheese 

5.7T 

Rabbit,  fat 

15.4T-2.22 

Radishes 

4T 

black 

4T 

Raisins 

5T 

Raspberries 

3T 

juice 

5.8T 

Red  beet 

4.5T 

cabbage 

4T 

herring 

6(T-A)+7.5F 

peppers,  dried 

Rhubarb 

4T 

Rice,  polished 

5.5T 

Roe 

■6(T-A)+7.5F 

Rolls 

5.8T 

Romadour  cheese 

6T+7.5F-0.3 

Roquefort  cheese 

6T+7.5F-0.3 

Rye  bread,  coarse 

5.2T 

fine 

5.5T 

flour 

5.5T 

Saffron 

Salmon,  fresh 

13.ST-1.57 

smoked 

6(T-A)4-7.5F 

trout 

5.7T 

Sardines  in  oil 

6CT-AH7.5F 

3T 

fat 

6(T-A)+7.5F 

13.5T-1.57 

5.7T 

4.5T 

11T-0.4 

6(T-A)+7.5F 

NEM  VALUE  OF  PRINCIPAL  FOOD-STUFFS  87 


Shrimps 

Skimmed  milk 

dry 

Smoked  bacon 

beef 

Snail 

Soja  bean 

Soup,  bouillon  broth 

medium 

thick 

thin 

Spinach,  fresh 

Spleen 

Sprat,  smoked 

Starch,  flour 

sugar 

Stew,  canned 

Stilton  cheese 

Strachino  cheese 

Strawberries 

Sturgeon,  fresh 

Sugar,  cane- 

beet- 

Sultanas 

Sweetbreads 

Swiss  cheese 

Syrup 

Tapioca 

Tomatoes 

preserved 

Tongue 

Topinambur 

Trout,  fresh 

Truffels 

Tunnyfish, canned 

Turbot 

Turkey 

Turnip-rooted  cabbage    (kohl 

rabi) 

Turnips 

oil 

Turtle  meat 

Udder 

Veal,  fat 

lean 

very  lean 

Vegetables,  cooked 

fresh 

Venison 


Nem 

in  1 

gram. 

Hekto- 
nem 

Protein 

weight, 
grams. 

value. 

1 

100 

9 

0.5 

200 

4 

5 

20 

4 

10 

10 

0.5 

4 

25 

4 

1 

100 

7 

4 

25 

3 

0.1 

1000 

3 

0.67 

150 

1 

1 

100 

1 

0.5 

200 

1 

0.4 

250 

3 

1.5 

67 

6 

3.3 

30 

4 

5 

20 

0 

5 

20 

0 

o!7' 

"15 

"2" 

6 

17 

2 

0.67 

150 

0.5 

1.25 

80 

8 

6 

17 

0 

6 

17 

0 

4 

25 

0.5 

1.5 

67 

9 

6 

17 

3 

5 

20 

0 

5 

20 

0 

0.25 

400 

2 

1 

100 

2 

3.3 

30 

3 

1 

100 

0.5 

1.5 

67 

9 

4" 

"25 

4" 

1.5 

67 

7 

2.5 

40 

4 

0.4 

250 

1 

0.4 

250 

1 

13.3 

7.5 

0 

1 

100 

6 

2.5 

40 

2 

2.5 

40 

4 

2.0 

50 

6 

1.5 

67 

8 

0A 

250 

"2  " 

1.5 

67 

8 

Formulas. 


6T 

13.5F+0.5 

5.5T-8F 

6(T-A)+7.5F 

6(T-A)+7.5F 

4.5T 

6(T-A)+7.5F 

6(T-A)+7.5F 

6(T-A)+7.5F 

6(T-A)+7.5F 

4T 

13.5T-1.57 

6(T-A)+7.5F 

6T 

5.9T 

6(T-A)-f7.5F 

6T+7.5F-0.1 

6T+7.5F-0.1 

5T 

5.7T 

5.9T 

5.9T 

5T 

5.5T+8F 

6T+7.5F-0.3 

5.9T 

6T 

4T 

4T 

13.5T-1.57 

5T 

13.5T-1.57 

3T 

6(T-A)+7.5F 

13.5T-1.57 

15.4T-2.22 

4T 
4.5T 
13. 5T 
6T 

6(T-A)  +  7.5F 

15.4T-2.22 

15.4T~2.22 

15.4T-2.22 

4T+9.5F 

4T 

6T 


88    THE  PIRQUET  SYSTEM  OF  NUTRITION 


Wafers 

Walnuts 

Wheat  bread,  coarse. . . . 
fine 

flour,  coarse 

fine 

Whey 

White  beet 

Wine,  heavy 

sour 

sweet 

very  sweet 

Zwieback,  coarse  (rusks) 
fine 


Nem 

in  1 

gram. 

Hekto- 

nem 
weight, 
grams. 

Protein 
value. 

Formulas. 

5 

20 

1 

5.8T 

9 

11 

0.5 

4.2T+8.3F 

3.3 

30 

1 

5.5T 

4 

25 

1 

5.8T 

5 

20 

1 

5.5T 

5 

20 

1 

5.8T 

0.4 

250 

1 

5.8T 

0.4 

250 

1 

4.5T 

0.2 

500 

0 

0.1 

1000 

0 

5T 

0.4 

250 

0 

1.0 

100 

0 

5 

20 

1 

5.5T 

•   •   •   • 

•   •   •    • 

.... 

5.8T 

PELIDISI  TABLE 


HOW  TO  FIND  THE  PELIDISI  BY  MEANS  OF  THE  TABLE 

Read  from  left  to  right  along  the  topmost  row  of  figures  until  you  reach 
the  predetermined  figure  giving  the  sitting  height;  then  read  down  the  cor- 
responding vertical  column  until  you  arrive  at  the  figure  which  is  the  weight 
of  the  individual;  then  follow  the  line  next  below  to  the  right  or  left,  and 
you  will  arrive  at  the  Pelidisi  figure.  If  the  figure  giving  the  weight  of  the 
individual  lies  at  a  point  between  two  figures  given  on  the  chart,  then  follow 
the  line  between  these  two  figures  as  directed  above. 

Example:  A  child  with  a  sitting  height  of  40  centimeters  and  a  net  weight 
of  5.40  kg. 

Look  for  figure  40  along  the  topmost  row  of  figures,  then  read  down  the 
corresponding  vertical  column  until  you  come  to  the  figure  5.40.  The  line 
below  this  figure  leads  to  (right  or  left)  the  Pelidisi  figure  95.  If  the  child 
has  a  sitting  height  of  40  centimeters  and  a  weight  of  5.20  kg.,  it  is  found 
that  this  latter  figure  lies  between  5.07  and  5.23.  In  this  case  follow  the  hori- 
zontal line  between  these  two  figures  to  the  Pelidisi  figure  93. 

All  particulars  about  this  table  are  to  be  found  in  Pirquet,  System  der  Ernah- 
rung,  Berlin,  Julius  Springer,  1919,  2d  part,  pp.  284-312. 


89 


-       SI  (Sitting  height) 


2      81 


32 


38     34      35     36      37 


38      39 


Weight 

in  Kilograms 

1-65 

1-71 

Ml 

205 

2  24 

243 

264 

2-86 

309 

334 

81    161 

1-77 

195 

213 

232 

2-53 

274 

297 

321 

346 

83 
167 

181 

202 

221 

241 

262 

2-84 

308 

333 

359 

1-73 

1-91 

209 

2-29 

250 

272 

205 

319 

345 

373 

84 

180 

R^l  — ...     . 

1-98 

217 

237 

259 

2;82 

306 

831 

358 

3-86 

1-86 

205 

2-25 

246 

2-68 

292 

317 

3-43 

8-71 

400 

86 

1-93 

212 

2-33 

254 

277 

302 

3-28 

355 

3-84 

414 

87 

200 

2-20 

241 

203 

2-87 

313 

339 

368 

397 

4-29 

88 

206 

227 

249 

272 

297 

323 

ft-51 

3*80 

411 

4  44 

8»  " 

214 
Bfl 

2-35 

258 

282 

307 

334 

363 

393 

425 

4-59 

2-21 

243 

206 

291 

318 

346 

375 

407 

4-40 

474 

VI 

228 

251 

275 

301 

328 

357 

8-88 

420 

454 

4-90 

8a 

236 

259 

2'84 

311 

339 

369 

401 

434 

409 

507 

244 

2-66 

2*94 

321 

351 

381 

414 

449 

4-85 

5-23 

34 

2  51 

2-77 

303 

382 

362 

394 

4-27 

4-63 

501 

5  40 

3D 

259 

2-85 

313 

342 

a-73 

406 

441 

4-79 

517 

5-58 

96 

268 

294 

323 

358 

385 

419 

455 

401 

5-33 

5~75 

97 

276 

304 

333 

304 

397 

432 

469 

5-09 

550 

593 

98 

285 

313 

343 

376 

4  10 

446 

4-84 

624 

567 

612 

99 
293 

ion 

323 

354 

387 

4  22 

460 

409 

541 

584 

6-30 

302 

333 

365 

3*99 

435 

4-74 

514 

5-57 

602 

6-50 

101 

312 

343 

376 

411 

4  48 

4-88 

6-30 

574 

620 

6-69 

821 

363 

3-87 

4-23 

402 

502 

545 

501 

6-39 

6-89 

lOo 

330 

803 

308 

436 

4-75 

517 

6  62 

608 

658 

7  10 

104 

340 

Htfi 

374 

410 

4  49 

4-89 

532 

5-78 

626 

6-77 

7  30 

350 

885 

422 

462 

503 

5-48 

505 

644 

6-97 

7  52 

100 

360 

396 

434 

475 

518 

564 

612 

663 

7-17 

773 

107 

370 

407 

4'46 

4-88 

5-33 

5-80 

629 

6-82 

7-37 

7-95 

108  "" 

380 

419 

459 

602 

5-48 

5-96 

647 

701 

7-58 

818 

109 

3-91 

UOr 

430 

472 

616 

563 

613 

605 

720 

779 

840 

40     £ 

& 


80 
81 

82 

83 

84 

8* 

86 

87 

88 

89 

90 

91 

92 

93 

94 

9--| 

96 

97 

98 

99 

100 

101 

102 

103 

104 

105 

106 

107 

108 

109 

110 


90 


Si  (Sitting  height) 


=   41   42 


80 
81 
62 
63 
64 
65 
66 
6? 
66 
69 
90 
91 
92 
93 
94 
95 
96 
9? 
98 
99 
100 
101 
102 
103 
104 
105 
106 
107 
106 
109 
110' 


43      44      45      46      47 


48 


49      50    = 
«> 

a. 


Weight  in  Kilograms 


360  3-86 


373  401 


3'87   416 


4*01    431 


4-16   447 


4-31   463 


4-46   4-80 


462   4-96 


4-78   514 


494    5-31 


415   4-44    475  508   542 


480   461  '4-93  5'27   562 


446   477    5-12   5'47    583 


4-63   4*96    531   5-67   605 


4-80   5-14    5-50   587   626 


4-97   532    570  608   6"49 


5-15    551    5-90  630   672 


5-33   571    610   652   696 


577   6-14   652 


599   6-37    6-77 


621    661    7-02 


644   6-85   7-28 


667    710   754 


6-91    735    781 


7-16   761    8-09 


5-61    5-90    6-32  675    720 


511    5-49 


5-28   5-68 


546   586 


5-63   606 


582   6-25 


6-00   6-45 


6-19   666 


639   6-87 


6-59   7-08 


679   7-30 


7  00   7-52 


7-21    775 


7  42   7-98 


7-64  821 


787    8-45 


810  870 


8-83   895 


856   9-20 


8-80   946 


905    973 


5-70   611    653  698   744 


589   631    675   721    770 


6-09   653   698  746   795 


629   674    7-21    770   822 


650   696    7  45   7-96   849 


670   7-19    7  69  821    876 


693    7'42    7-94   8"48   904 


714   7-66    819  875   933 


737    7-90    8'45  9*02   962 


760   814    871    9-30   992 


783   8-39    8-98  9"59    10  2 


8-07   865    925  9'88    105 


7-41    7-88   8-37 


7-67    8-15   866 


793   8-44   896 


820   872    927 


8-47    901    958 


875    931    989 


9-04   962    102 


933   993    105 


9-63    10-2    109 


994    106    112 


103    109    116 


106    H-2    11-9 


109    11  6    123 


112    11-9    127 


831    8-91    953   10-2    10  9 


8-56    917    981    105    112 


8-82   9-44    10-1    108    115 


907   972    104   HI    118 


934    100    107   11-4    12-2 


960    103    11-0   11-8    12-5 


988    106    113   121    12-9 


10  2    109    116   124    183 


104    112    120   12-8    13*6 


116    123    131 


11-9    127    136 


123    130    139 


12-6    13-4    143 


130    13-8    147 


13-4    142    151 


137    146    155 


14-1    150    160 


145    154    164 


60 
81 

62 
63 
64 
65 
66 
8? 
66 
"  89 
-  90 
"  91 
■  92 
93 
94 
95 
96 
97 
98 
99 
100 
101 
102 
103 
104 
105 
106 
107 
108 
109 
110 


91 


■ 

(Sitting  height) 

*8 

5      51 

52 

53 

54 

55 

66 

57 

58 

59 

60 

2 

"5 

P- 

80 

•  81 
82 
83 
84 

692 

7  33 

777 

8-21 

8-68 

916 

9-66 

102 

10-7 

11-3 

81  718 

7*61 

806 

852 

901 

961 

100 

106 

111 

11*7 

82  7-46 

7-90 

836 

884 

984 

986 

10-4 

11-0 

11-5 

121 

83  7.?2 

819 

867 

917 

969 

103 

108 

1L'4 

120 

12-6 

84  8-00 

8'48 

8-98 

950 

100 

106 

11-2 

11-8 

124 

13-0 

85 
8*29 

879 

931 

984 

10-4 

110 

11-6 

12-2 

128 

135 

86 
87 
88 
89 
90 

86  859 

910 

964 

102 

108 

114 

120 

12-6 

13-3 

140 

8?  889 

9-42 

997 

105 

111 

11-8 

124 

131 

13-8 

14-5 

88  919 

975 

103 

109 

115 

12-2 

128 

13-5 

14-2 

150 

89  9-51 

101 

10-7 

11-8 

119 

126 

13-8 

140 

147 

155 

90  *' 
983 

104 

110 

11-7 

123 

130 

13-7 

145 

15-2 

160 

91  102 

108 

11-4 

121 

127 

13-5 

142 

149 

15-7 

16-6 

91 

92 
93 

*  105 

111 

11-8 

125 

132 

139 

146 

15-4 

163 

171 

W  108 

11-5 

122 

129 

136 

14'4 

151 

15-9 

168 

17-7 

94  11-2 

11-9 

126 

13-3 

140 

14-8 

156 

165 

173 

18-2 

94 

9". 

9u  -       ■ 

11-6 

122 

130 

137 

145 

153 

161 

170 

17-9 

18-8 

96 
97 
9S 
99 
100 

Wll-9 

126 

134 

141 

150 

158 

16-6 

17-5 

184 

19-4 

W  123 

130 

138 

146 

154 

163 

171 

181 

190 

20-0 

98  1*7 

134 

14-2 

150 

159 

168 

17-7 

18-6 

196 

20-7 

"  131 

139 

14-7 

155 

164 

17-3 

182 

192 

20-2 

21-3 

100    ■■ 

135 

143 

151 

160 

16-9 

178 

18-8 

19-8 

209 

21-9 

101 
102 
103 

101  13  9 

147 

15-6 

16-5 

17  4 

184 

194 

204 

216 

22-6 

m  14  4 

152 

160 

170 

179 

189 

199 

210 

221 

233 

103  147 

156 

165 

175 

18-4 

195 

205 

216 

22-8 

240 

101  151 

160 

170 

180 

19-0 

200 

211 

22-3 

23-5 

246 

104 

105 

105  -  ■ 

156 

16-5 

17-5 

185 

195 

206 

217 

22-9 

241 

25-4 

106 

160 

170 

180 

190 

20-1 

212 

22'4 

236 

248 

260 

106 
107 
108 

l0V  16-5 

175 

185 

196 

20-7 

218 

230 

242 

25-6 

26-8 

m  169 

180 

190 

201 

213  224 

23-6 

249 

268 

27-6 

109 
174 

110 

18-6 

195 

207 

218  230 

243 

25-6 

270 

28-4 
——110 

92 


•5     SI  (Sitting  height) 


=     61 

X 


62 


63      64      65      66      6" 


6S      69 


»     5 

0. 


80 

81 
83 
83 

84 
85 
86 
87 
88 
89 
90 
91 


Weight  in  Kilograms 


11-8   12*4 


123    129 


12-7    134 
13*2    139 


137    144 


142    14-9 


147    154 


152    160 


157    16a 


163    171 


168    17-7 


174    183 


180    189 


94 
93 

96 
97 


186    195 


130    137    143    150    157 


135    142    149    156    163 


140    147    154    161    169 


146 .  153    160    16  7    175 


151    158    166    174    181 


15-6    164    172    18-0    18-8 


162    170    178    186    195 


167    17-6   18-4    193   201 


.17-3    18-2    190    199   208 


164    171    17-9 


170    178    186 


31 


17?    185    193 


-  82 


183    191    200 


83 

S4 

190    198   207 

85 

196    205    214 

S6 

87 


203   21-3   222 


21  1    220   230 


218   228   238 


—   88 


179    188    197   206   216 


185    194   204   213   223 


19-2   20-1    21-0  220   230 


19-8   207   21-7   228   238 


204   21-4   224    235   246 


19-2   201 


198   208 


204   214 


211    22*1 


99 
10U 
101 
102 
103 
104 
105- 


217   22-8 


224   23-5 


230   24-2 


23-7    24-9 


244   25-7 


252   26-4 


259   27-2 


106- 


267    280 


107- 


27  4   28-8 


108- 


28  2   29-6 


109 

110- 


290   30-4 


298   313 


211    22-1    232    243   254 


218   22-8   23-9   250   262 


225   236   247   258   270 


232   243   25-5   266   279 


239   250   26-2   275    287 


24-6   25-8   271    28'3   296 


25'4   26-6    27-9   29'2    305 


261    274   287   301    31*4 


269   282    296  310   324      339   354  369 


22-5   236   24-6 


233   244   254 


241    25-2   263 


24-8   260   27-2 


89 

90 
91 
92 
93 
94 
95 
96 

97 

29>2   305   318 

—    93 


257   269   28-0 


265   278  29-0 


274   286  299 


28-3   295   308 


301    31-4  328 


310   324  33-8 


99 


31-9   333  348 


—  100 


329   343  359 


277    291 '305  319    38M 


285   299    313   328    34'3 


294   308    322  338    353 


302   317    33-2   347    363 


311    32-6    34-2  357    374 


319   335    351   367    384 


32-8   344    361   377    39  5      413   431  450 


349   36  4  380 


359   375  391 


369   386  40-3 


380   397  41'4 


39- 1    408  426 


402   42  0  438 


101 
102 
103 
104 
105 
106 
107 
108 
109 
110 


93 


05 

5    « 


Si  (Sitting  height)      , 


73      74       75      76      77 


78      79 


^0     = 

41 


SO 

hi 

82 
84 


Weight  in  Kilograms 


187    195 


194    20-2 


201    21-0 


20-8    21-7 


216   225 


224    233 


SO 
87 
SS 
S9 
90 
91 
92 
93 
94 
JK> 
96 
97 
98 
99 
100 
101 
102 
103 
104 
10') 
106 
107 
108 
109 
110 


232   241 


240    250 


24-8    259 


257   268 


265    27-7 


27  4    286 


203  211    220  229   23"8 


211    219    228  237   247 


248   257    26-7 


218   227    237  246   256 


226   236    246  255   266 


235   244    25-4  2fr5   27-5 


243   25-3    26-4  27  4    285 


25-2   26-2    273  28-4   295 


26- 1    271    283  29'4    30-6 


270   28-0    292  304   316 


279   29-0    302  31 5   827 


288   30-0    313  32"5   338 


298   310    323  336   350 


257    267    27-7 


267   27-7    287 


276    28-7    298 


286   298    30-9 


297    30'8    32-0 


307    31*9    33-1 


80 
81 

82 
83 
84 
S5 

86 


318   331    343 


r  87 


32-9   342    355 


34-0   35-4    367 


352   366    380 


364   378    392 


283 

295 

308 

321 

334 

347 

361 

37-6 

390 

40-5 

29-3 

30-5 

31-8 

331 

345 

359 

37-3 

388 

40-3 

41 

302 

315 

328 

34-2 

356 

370 

38-5 

401 

41'6 

432 

31  2 

325 

339 

353 

367 

382 

398 

413 

42-9 

44-6 

322 

335 

35-0 

364 

37-9 

394 

410 

42-6 

443 

460 

332 

346 

36-1 

376 

391 

407 

423 

440 

457 

475 

34*2 

357 

372 

387 

403 

42-0 

436 

454 

471 

489 

353 

368 

38-3 

899 

415 

43-2 

45-0 

468 

486 

50-4 

363 

379 

395 

411 

428 

446 

46-3 

48-2 

501 

520 

37  4 

390 

40  7 

424 

441 

45-9 

47-7 

496 

516 

535 

366 

402 

419 

436 

454 

473 

49-2 

511 

531 

551 

397 

414 

431 

449 

468 

487 

506 

52-6 

54-7 

568 

409 

426 

444 

46-2 

481 

50-1 

52-1 

542 

563 

587 

42*0 

438 

457 

476 

495 

515 

536 

558 

57  9 

601 

432 

451 

470 

490 

510 

530 

551 

574 

596 

618 

445 

464 

483 

503 

524 

545 

567 

590 

613 

636 

457 

477 

497 

518 

53-9 

561 

583 

606 

63-0 

654 

470 

490 

511 

682 

55-4 

577 

600 

628 

647 

673 

88 
89 
90 

91 

92 
93 
94 

95 

96 
97 

98 

99 

100 

101 
102 
L03 
104 

105 

106 
107 
108 
109 
110 


94 


•3 


Si  (Sitting  height) 


■a     81     82 


4> 


80 
81 
82 
S3 

S4 

85 
86 
87 

«ss 

«9 

90 

91 

92 

93 

94 

95- 

96 


83      84      85      86     87 


to 


88     89     90     = 

a. 


27-7    28-8 


28-8    299 


29-8    310 


309   32-1 


32' 1    333 


298   30'9   32-0  832  344 


310   321    33  2  344  357 


32- 1    333    345  35'7  37'0 


33-3   345    358  37  0  384 


34-5   358    371   38*4  397 


33-2   34-5 


344    357 


356    369 


36-8    382 


381    39-5 


39-4    40-9 


407    422 


421    43-6 


356  368   380 


:—  SO 


369  382   395 


7  81 


383  396   40-9 


~  82 


39  7  410  424 


411  425   440 


357    371    384  39-8  41*2 


37-0    384    397  41'2  42  6 


383    397    411   426  441 


396    41  1    42-6  441  456 


410    42-5    440  456  47-2 


424    439    45-5  47  1  488 


43-8    454    470  487  50'4 


434    45  1 


44-8    46-8 


463    48-0 


97 
98 

9ft 
100 
101 
102 
103 
104 
JOT. 
100 
107 
108 
109 


478    49-5 


49-3    51-1 


50-8    527 


52-3    543 


54-0    560 


556    577 


45-3    469    48  6  50"3  521 


467    48  5    502   520  538 


482    50-0    51-8   537  556 


49-9    51-6    534   55  4  574 


514    533    55-1    572  592 


530    54-9    56-9    590  61-0 


547    567    58-6    60-8  62"9 


563    584    605    627  649 


58-0    602    623   646  668 


59-8    62-0    642   665  690 


573    594 


590   61-1 


607    62-9 


624    648 


642    666 


660    685 


679    704 


110 


61-6    638    661    68  5  70  9 


426  44-1    45  6 


441  45-6   472 


457  47-2   48-8 


47-2  48-9   505 


48-9  505   523 


505  52-3    540 


522  54-0    558 


539  55  8    577 


557  576    596 


575  595    615 


594  61  4    63  5 


612  63  4    65o 


632  653   67  6 


83 
S4 

So 

86 
87 
88 
89 
90 

91 
92 
93 

94 

95 

96 
97 


65-1  67-4   697 


~  98 


671  69-4   71  8 


692  71  6   74  0 


71-3  737   76-2 


734  759   785 


63-4   65  7    681    70  5  73'0 


653    676    70  1    726  751 


672    696    72'1    74-7  77-3 


69-1    71-6   74-2    768  795 


71-0    73-8   763    79  0  818 


730    75-7   784    812  84"1 


698   72-4     75  1    778  806    835  865 

95 


756  78-1  808 


77-8  80-4  83  2 


80-0  82-7  85  6 


82-3  85- 1  88  0 


847  87-5  90-5 


870  900  93- 1 


89-5  92-6  957 


99 
100 

101 
102 
103 
104 

105 

106 
107 
108 
109 

110 


Si  (Sitting  height) 


CL 


80 
81 

82 
83 

84 
85 
86 
87 
K8 

91 

92 

93 

94 

95 

96 

97 

08 

99 

100 

101 

102 

103 

101 

105 

1.06 

107 

108 

109 

110 


=  91   92    93   94   95 


96   97 


98 


99   100  =j 

CL 


1 

Weight  in  Kilograms 

393 

406 

42-0 

433 

447 

46-2 

47-6 

491 

50-6 

52-2 

408 

422 

436 

450 

464 

479 

49-4 

50-9 

52-5 

541 

423 

43-7 

452 

466 

481 

497 

51-2 

52-8 

545 

56-2 

439 

453 

468 

48-4 

49-9 

51-5 

631 

54-8 

565 

58-2 

455 

470 

485 

501 

51  7 

53-4 

551 

568 

58*6 

603 

471 

48-7 

503 

51-9 

536 

553 

571 

688 

606 

625 

48-8 

504 

521 

53-8 

55-5 

57-3 

591 

60-9 

628 

64-7 

50*5 

522 

539 

557 

57-4 

593 

61-2 

630 

650 

67-0 

52-2 

54-0 

558 

57-6 

594 

613 

63-8 

65-2 

67-3 

693 

540 

558 

57-7 

59-5 

615 

634 

65-5 

675 

696 

71-7 

559 

577 

59-6 

61-6 

635 

65-6 

676 

69-8 

71-9 

74- 1 

577 

596 

61-6 

636 

657 

67-8 

69-9 

721 

743 

766 

596 

616 

63-7 

657 

67-9 

70-0 

72-2 

74-5 

76-8 

79-1 

61-6 

63-6 

65-7 

67-9 

701 

723 

74-6 

769 

793 

81-7 

636 

65-7 

67-9 

701 

724 

74-7 

77-0 

79-4 

81-9 

844 

656 

67-8 

701 

723 

747 

771 

796 

82-0 

84-5 

871 

677 

70-0 

723 

746 

770 

795 

820 

846 

87-2 

899 

698 

72-2 

745 

770 

795 

82-0 

84-6 

87-2 

89-9 

92-7 

720 

744 

769 

79-4 

819 

846 

872 

899 

92-7 

956 

742 

767 

792 

81*8 

845 

87-2 

899 

927 

95-6 

985 

765 

790 

816 

84-3 

870 

89-8 

92-6 

955 

98-4  1015 

788 

61-4 

841 

868 

897 

92-5 

96-4 

98-4  101-4  1046 

811 

839 

866 

894 

92-3 

953 

98-3 

101-8  1044  107-7 

835 

86-3 

892 

921 

951 

981 

1012 

1043  107-6  UO-9 

86-0 

889 

91-8 

948 

981 

1010  104-2 

1074 

110-7  114-2 

885 

914 

944 

975  100  7 

103-9 

107-2 

1105  113-9117  4 

9J0 

S40 

972 

100-3  1036 

106-9 

1103 

113-7 

117-2120-8 

936 

967 

999 

103-2  1065 

109-9 

1134 

116-9 

120-5  124-2 

962 

995 

102-7 

106-1  1095 

1130 

116-6 

1202 

1239  127  7 

989 

1022 

1056 

10>0  1126 

116-2  119-8 

123-6  127-6  131-3 

80 
81 

82 
S3 
84 
85 

86 
87 
88 
89 
90 

91 
92 
93 
94 
.95 

96 
97 

98 

99 

100 

101 
102 
103 
104 

105 

106 

:107 

108 
109 
110 


96 


K- 


UNIVERSITY    OF    CALIFORNIA    LIBRARY, 

BERKELEY 


THIS  BOOK  IS  DUE  ON  THE  LAST  DATE 

STAMPED  BELOW 

Books  not  returned  on  time  are  subject  to  a  fine  of 
50c  per  volume  after  the  third  day  overdue,  increasing 
to  $1.00  per  volume  after  the  sixth  day.  Books  not  in 
demand  may  be  renewed  if  application  is  made  before 
expiration   of  loan   period. 


2    J& 


fc?H 


IS 


x& 


HQV 


OCT  SI 


JUL  22    1940 

JUL  26  1941 

Sj 


MAR  24  IS 


1931 


50m-7,'29 


RM2K, 


UBRAP 


UNIVERSITY  OF  CALIFORNIA  LIBRARY 


f    "<1 


• 

/ 

K 

i 

;    i 


